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Child passed small black worm in urine. What kind of parasite this could be?

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Infectious Diseases Specialist
Practicing since : 2000
Answered : 180 Questions
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Yes, my daughter has just returned from Roatan, Honduras a week ago. Today she passed a small black
worm in her urine. She feels fine now, but I am wondering what kind of parasite this could be?
Posted Sat, 6 Jul 2013 in Infections
 
 
Answered by Dr. Binod Kumar Pati 9 hours later
Hi,
A warm welcome
If you could update me her clinical picture before the worm passed out it. Will be helpful for me to evaluate. Also if you have the it upload a picture or video of the worm to facilitate identification.
Since all of them appear as parasites or stones it is difficult to identify.
Shall be waiting for more details.
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Follow-up: Child passed small black worm in urine. What kind of parasite this could be? 37 hours later
I do not have a picture of the worm. She saw it and flushed it without thinking.
 
 
Answered by Dr. Binod Kumar Pati 3 days later
Hi,

I apologize for the delayed response.

Worm in the urine is very uncommon condition. Most of the human parasitic worms are passed out by stool and other body orifices. Two worms which are known to break mucosal barrier and pass through urine are Schistosoma and Strongyloides; however such occurrence are possible if her body resistance is compromised.

Heart murmur and beta-blocker medications are not sufficient to cause immunocompromisation. Therefore I feel what your daughter has isn't related to worms. It perhaps may be a cast, cystal or epithelial cells resembling a worm.

In this circumstance, I suggest you to wait and observe for appearance of similar substances. Get her urine tested if symptoms recur.
If you do not wish to wait, blood eosinophil count can provide clues to know whether or not she has parasitic infestations. Your local doctor will know about this test.

I hope this information is sufficient and helpful.

Take care
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Follow-up: Child passed small black worm in urine. What kind of parasite this could be? 13 hours later
Would a cast, cystal or epithelial cell will move like a worm? She said it
wiggled at the bottom of the toilet bowl.
 
 
Answered by Dr. Binod Kumar Pati 3 days later
Yet again I am sorry.

Urinary solutes (cast and crystal) and epithelial cells do not wiggle like worms at the bottom of the toilet bowl. In this instance, the best way forward is to get her tested. Blood test for eosinophil count and routine / microscopic examination of urine will give us clues to confirm parasitic infections.

Regards
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