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What causes black worms in urine?

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Posted on Wed, 2 Jul 2014
Question: My daughter found three black worms in her urine. They are about three inches long and one was larger than the other two. Last week she found two black worms. A few days before that she found small worms and what looked to be eggs. She was having stomach pain. I took her to the emergency room with the evidence. They would only test the urine taken while we were there and said she had a UTI and gave her 3 days of Cipro. How can we get rid of these worms? The ER refused to send the two we found for analysis. She is afraid they will do something to her and so am I.
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Answered by Dr. Shoaib Khan (1 hour later)
Brief Answer:
Urine worms seem unlikely, shall explain

Detailed Answer:
Hello and welcome.

Thank you for writing to us.

I have gone through your query with diligence and can understand how frustrated you feel due to the response you recieved from the medical staff you met, I shall explain why they reacted how they reacted, but do not agree with the fact that they did not take time to explain things to you and your daughter. Either way, I shall help you with that sir/ma'am.

To start with, in majority of the cases (~90%) the worms noticed while passing urine have not actually come along with the urine. As the bladder is not a suitable environment for worms to strive, they do not inhabit themselves there. Most of the individuals who notice worms in the toilet bowl after passing urine have two most common sources:
1. The toilet bowl/comod itself
2. The worms find their way out through the anus during the act of urination

The second option is the most common one, as these worms inhabit themselves in the intestine, and while the act of passing urine takes place, they exit from the anus. This sensation most times goes unnoticed, making the individual think the worms came along with the urine.

A reason why the worms in the intestine are more likely is due to your daughters symptom of stomach pain, which is usually associated with parasite infestations of the gastrointestinal tract (GIT).

The medical staff you consulted cannot use the worms that you brought to them as these would not be helpful in the laboratory. The worms need to be found from the source and have to be uncontaminated by the surroundings.

The reason why the medical staff can only treat the UTI as of now, is because the parasite infestation has not been confirmed. For this I would recommend you to revisit your doctor and get your daughters stool examined.

As for parasites along with urine, there is only one such parasite that can inhabit itself in the bladder and come out with the urine. It is called schistosoma. This is a rare parasite found usually in third world countries and affects individuals who drink or bath in dirty contaminated srream water, which in my opinion could be unlikely for your daughter. Also important to note is that with schistosoma infestation the individual becomes severely sick much before the worms start leaving the anus. You have not mentioned any serious health issues with your daughter other than the stomach pain and the worms passing out, making schistosoma unlikely sir/ma'am. Do let me know if this is or is not the case.

I hope you find my response both helpful and informative. Please feel free to write back to me for any further clarifications, I would be more than happy to help you. Please do consider the possibility of intestinal parasites.

Best wishes sir/ma'am.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shoaib Khan (9 hours later)
Thank you for explaining why the ER staff did not send our sample to the lab. I was upset because they would not even look at the two worm specimens that were in the urine. My daughter's urine separated into two layers. One layer looked like normal yellow urine. The other layer looked was a cloudy layer with small eggs/seeds and small moving pieces. The ER doctor did a pelvic exam and noticed that my daughter had a brownish fluid coming from her vagina. Are there any known worms that can inhabit the vagina?

One of my biggest worries is that on May 2nd, my daughter and three other people, including myself, ate at a Mexican restaurant and got food poisoning. I have been trying to research parasites and realize that most of them come from contaminated water or food. Maybe it is unlikely the majority of the time for parasites to come from the urine but her urine sample was very suspicious and she had food poisoning about one month before this occurred. Is it possible to get a parasite infection in your urinary tract from food poisoning?

doctor
Answered by Dr. Shoaib Khan (2 hours later)
Brief Answer:
Yes it is possible; that is unlikely sir/ma'am

Detailed Answer:
Hello and welcome.

Yes of course there are parasites that can inhabit the vagina, one of the most common ones that are found in practice are called Trichomonas vaginalis.

In my opinion, with the added history of food poisoning the possibility of a parasitic infection in the GIT is more likely sir/ma'am. Although, we cannot rule out the parasites from your daughter's urine, it is something we should consider only after the parasitic infection from the GIT is ruled out.

I hope I have successfully addressed the issues you needed information for sir/ma'am. Please feel free to write back to me for any further clarifications, I would be more than happy to help you.

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shoaib Khan

General & Family Physician

Practicing since :2009

Answered : 9409 Questions

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What causes black worms in urine?

Brief Answer: Urine worms seem unlikely, shall explain Detailed Answer: Hello and welcome. Thank you for writing to us. I have gone through your query with diligence and can understand how frustrated you feel due to the response you recieved from the medical staff you met, I shall explain why they reacted how they reacted, but do not agree with the fact that they did not take time to explain things to you and your daughter. Either way, I shall help you with that sir/ma'am. To start with, in majority of the cases (~90%) the worms noticed while passing urine have not actually come along with the urine. As the bladder is not a suitable environment for worms to strive, they do not inhabit themselves there. Most of the individuals who notice worms in the toilet bowl after passing urine have two most common sources: 1. The toilet bowl/comod itself 2. The worms find their way out through the anus during the act of urination The second option is the most common one, as these worms inhabit themselves in the intestine, and while the act of passing urine takes place, they exit from the anus. This sensation most times goes unnoticed, making the individual think the worms came along with the urine. A reason why the worms in the intestine are more likely is due to your daughters symptom of stomach pain, which is usually associated with parasite infestations of the gastrointestinal tract (GIT). The medical staff you consulted cannot use the worms that you brought to them as these would not be helpful in the laboratory. The worms need to be found from the source and have to be uncontaminated by the surroundings. The reason why the medical staff can only treat the UTI as of now, is because the parasite infestation has not been confirmed. For this I would recommend you to revisit your doctor and get your daughters stool examined. As for parasites along with urine, there is only one such parasite that can inhabit itself in the bladder and come out with the urine. It is called schistosoma. This is a rare parasite found usually in third world countries and affects individuals who drink or bath in dirty contaminated srream water, which in my opinion could be unlikely for your daughter. Also important to note is that with schistosoma infestation the individual becomes severely sick much before the worms start leaving the anus. You have not mentioned any serious health issues with your daughter other than the stomach pain and the worms passing out, making schistosoma unlikely sir/ma'am. Do let me know if this is or is not the case. I hope you find my response both helpful and informative. Please feel free to write back to me for any further clarifications, I would be more than happy to help you. Please do consider the possibility of intestinal parasites. Best wishes sir/ma'am.