Barreto Nilo M P V, de Souza Joelma N, Araújo Weslei A C, Khouri Nadia A, de Oliveira Ernesto P, Teixeira Márcia C A, Soares Neci M
Faculdade de Farmácia, Universidade Federal da Bahia-R. Barão de Jeremoabo, 147 Ondina, Salvador BA, 40170-115, Brazil.
J Parasitol. 2018 Aug;104(4):433-437. doi: 10.1645/17-88. Epub 2018 May 15.
The objective of this study was to report a case of a hydronephrotic patient with Strongyloides stercoralis infection, with discharge of rhabditoid larvae exclusively in urine. In 2013, a 72-yr-old male patient, hypertensive, obese, and diagnosed with hydronephrosis secondary to renal calculi, reported lumbar pain, polyuria, polaciuria, and dysuria, as well as frequent urinary tract infections. The microscopic analysis of urine sediment showed the presence of S. stercoralis rabditoid larvae. However, parasitological examinations by Baermann-Moraes, agar plate culture, and spontaneous sedimentation performed with 3 fecal samples on alternate days had negative results. The patient was treated with albendazole and to date has shown negative results in both parasitological and urine tests. This report deals with the unusual finding of S. stercoralis in a urine sample of an immunocompetent individual and absence of disseminated infection, but with hydronephrosis. Patients with nephropathies from S. stercoralis-endemic areas should be monitored periodically, as early detection may prevent the worsening of symptoms and renal failure.
本研究的目的是报告一例患有粪类圆线虫感染的肾积水患者，其尿液中仅排出杆状蚴幼虫。2013年，一名72岁男性患者，患有高血压、肥胖症，被诊断为肾结石继发肾积水，报告有腰痛、多尿、烦渴多饮和排尿困难，以及频繁的尿路感染。尿液沉渣显微镜分析显示存在粪类圆线虫杆状蚴幼虫。然而，采用贝曼-莫雷斯法、琼脂平板培养法以及对3份粪便样本隔天进行的自然沉淀法进行的寄生虫学检查结果均为阴性。该患者接受了阿苯达唑治疗，迄今为止，寄生虫学检查和尿液检查结果均为阴性。本报告涉及在一名免疫功能正常个体的尿液样本中发现不寻常的粪类圆线虫，且无播散性感染，但伴有肾积水。来自粪类圆线虫流行地区的肾病患者应定期监测，因为早期发现可能预防症状恶化和肾衰竭。
