Abstract
Dioctophyma renale is one of the largest parasitic nematodes of mink, wolves, dogs, cats and other carnivorous mammals. The adult worm is most commonly found infecting the renal pelvis hence has been named as the giant kidney worm. Primarily being an incidental zoonotic disease, human infections by D. renale are rare with only a few cases reported worldwide. Humans acquire the infection after consuming raw or undercooked paratenic hosts (fish or frog) containing infective larvae of D. renale. Although majority of the cases reported so far have renal involvement, cases involving ectopic sites such as subcutaneous tissues and retroperitoneal cavity have also been reported. Loin pain and haematuria are the most common presenting symptoms in human dioctophymiasis. Diagnosis of dioctophymiasis may be achieved by direct demonstration of the characteristic eggs or worm in the urine or on stained tissue sections of affected organ(s). No definitive treatment is available till date, though different approaches including empirical use of various anti-helminthic agents, removal of worm and in severe infections nephrectomy have been attempted with varying success.
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Case Study
Case Study
A 32-year-old male patient was admitted with complains of urine retention for 1 day. He also gave history of passing blood in the urine for the past 5 days and right loin pain for over an year. On general physical examination, pallor and tachycardia were noted. His laboratory investigations revealed leukocytosis and haemoglobin 8.0 gm/dL. The patient was catheterized and urine analysis revealed the presence of albumin in traces, 12–15 RBCs/hpf and numerous pus cells. The patient passed a red-coloured worm in his urine which was morphologically identified as D. renale. Further examination of urine sample did not reveal presence of any other parasitic element including eggs/ova or cysts.
Questions
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What are the other parasites which can cause urinary problems?
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How can you identify the worm?
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What are the treatment options for this condition?
Research Questions
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Which technique should be adopted or developed for the diagnosis and screening of Dioctophyma infections?
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What should be the drug of choice in the treatment of dioctophymiasis?
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How to improve our understanding regarding the epidemiology of human dioctophymiasis?
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Khullar, S., Verma, N., Mirdha, B.R. (2022). Dioctophymiasis. In: Parija, S.C., Chaudhury, A. (eds) Textbook of Parasitic Zoonoses. Microbial Zoonoses. Springer, Singapore. https://doi.org/10.1007/978-981-16-7204-0_46
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DOI: https://doi.org/10.1007/978-981-16-7204-0_46
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