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Tuesday, September 09, 2014

Worms in the Urine: Strange Facts

Many people have heard of parasitic worm infections in their animals and even in humans. In those cases, people generally are familiar with worms being found in the fecal matter. However, many people are unaware that people can actually urinate worms. The reason is because some types of worms can infect the urinary tract.

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One type of worm infection is trichomoniasis, but these worms are microscopic. Another worm infection is schistosomiasis, which is caused by a worm called a fluke. This can cause severe kidney failure, blood in the urine, blockage of urine flow, and can eventually result in bladder cancer. In cases of fluke infection, worm eggs are released in the urine from the worms that live in blood vessels around the urinary bladder.

 Another parasitic worm infection is filariasis, which is threadworm infection. This can cause lymph fluid to enter the urine and a severe enlargement of tissues (elephantitis).  Yet another parasitic worm infection that can rarely present in the urine is strongyloidiasis which is caused by a type of roundworm.  Sometimes, the worms are living and swimming freely in the urine.  Identification of worms such as these in urine samples can sometimes prevent fatal health outcomes as these conditions are often treatable and reversible with medication.

Another type of roundworm infection that can rarely present in the urine is Ascaris lumbricoides (see picture above, image copyrighted by the Journal of Postgraduate Medicine).  These worms can live in the body for 12 to 18 months and can produce 240,000 eggs.

One of the earliest accounts of a worm present in the urine occurred in 1677 by a man named Matthew Milford. Mr. Milford noted that worm he passed was snake-headed and alive. He noted that it was small at the tail. He noted being very ill before hand and that since that time he had blood in the urine. He reportedly probably had urinary retention for some time. The worm presented on the second urine, leading the writer of the article to hypothesize that it descended from the kidney to the bladder initially and then out into the urine stream. The worm was then noted to be dead, dry, and a dull red color, with a thickness of 1/12th of an inch. It is unclear exactly what type of worm this was.

Reference : Ent and Milford (1677). A Relation of a Worm Voided by Urine; Communicated by Mr. Ent: to Whom It Was Sent by Mr. Matthew Milford. Philosophical Transactions, 140, 1009.

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