Division of Hospital Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Am J Trop Med Hyg. 2020 Jun;102(6):1396-1398. doi: 10.4269/ajtmh.19-0956.
Strongyloidiasis is a disease caused by the parasite in humans. We present a case of incidentally discovered urinary tract infection in a patient in whom there was a urologic surgery consisting of urinary diversion created by self-bowel transplantation and conduit creation. Historical review demonstrated eosinophilia before surgery and detection of the parasite. Social review demonstrated endemic exposure. Our patient's case was differentiated from hyperinfection by the presence of rhabditiform larvae, and not filariform larvae, in the urine, suggesting localized small bowel infection was transferred to the urinary tract secondary to the creation of the ileal loop conduit. This patient's clinical course improved with antibiotic treatment of the bacterial infectious complications of surgery and resolution of infection with ivermectin. To our knowledge, this is the first case of infection of the urinary tract secondary to ileal loop conduit creation and not as a result of hyperinfection.
类圆线虫病是一种由寄生虫引起的疾病。我们报告了一例偶然发现的尿路感染病例,该患者曾接受过泌尿外科手术,包括由自体肠移植和导管形成的尿路改道。病史回顾显示手术前存在嗜酸性粒细胞增多症和寄生虫检测。社会史显示存在地方性暴露。我们的患者病例与过度感染不同,尿液中存在杆状幼虫,而不是丝状幼虫,这表明局部小肠感染通过回肠造口管的形成转移到泌尿道。该患者的临床病程通过手术细菌感染并发症的抗生素治疗和伊维菌素治疗感染得到改善。据我们所知,这是首例由于回肠造口管形成而不是由于过度感染导致的泌尿道类圆线虫感染。