Shrestha Rayana, Sharma Nava R, Wagle Abhishesh, Pokhrel Madalasa
Department of Internal Medicine, Institute of Medicine, Maharajgunj, Kathmandu, NPL.
Department of Internal Medicine, Maimonides Medical Center, Brooklyn, USA.
Cureus. 2025 Aug 4;17(8):e89317. doi: 10.7759/cureus.89317. eCollection 2025 Aug.
Ascariasis is primarily an intestinal parasitic infection, with ectopic migration to the genitourinary tract, representing an uncommon clinical entity. Such presentations are infrequently reported and may pose a diagnostic challenge, particularly in the absence of gastrointestinal symptoms. We report a case of an 88-year-old female from a suburban region of Nepal, who presented with bilateral iliac pain and dysuria of three days' duration. Physical examination was notable for mild lower abdominal tenderness, with stable hemodynamic parameters. Laboratory investigations revealed leukocytosis with neutrophilic predominance. Urine microscopy demonstrated the presence of a motile helminth, subsequently identified as . The patient denied gastrointestinal complaints, fever, or any prior history suggestive of helminthic infection. This case illustrates a rare presentation of urinary ascariasis diagnosed through conventional urine microscopy in the absence of gastrointestinal manifestations. The diagnosis was established using basic diagnostic modalities available in a suburban healthcare setting, underscoring the continued relevance of routine microscopy in detecting atypical parasitic infections. Although rare, urinary ascariasis should remain a differential consideration in patients from endemic areas presenting with urinary tract symptoms. In resource-limited settings, fundamental laboratory techniques continue to play a critical role in identifying uncommon infectious etiologies.
蛔虫病主要是一种肠道寄生虫感染，可异位迁移至泌尿生殖道，这是一种不常见的临床情况。此类表现鲜有报道，可能会带来诊断挑战，尤其是在没有胃肠道症状的情况下。我们报告一例来自尼泊尔郊区的88岁女性病例，她出现双侧髂部疼痛和持续三天的排尿困难。体格检查发现轻度下腹部压痛，血流动力学参数稳定。实验室检查显示白细胞增多，以中性粒细胞为主。尿液显微镜检查发现有活动的蠕虫，随后鉴定为 。患者否认有胃肠道不适、发热或任何提示蠕虫感染的既往史。该病例说明了在没有胃肠道表现的情况下，通过传统尿液显微镜检查诊断出的罕见的泌尿生殖道蛔虫病。诊断是使用郊区医疗机构可用的基本诊断方法确立的，强调了常规显微镜检查在检测非典型寄生虫感染方面的持续相关性。尽管罕见，但对于来自流行地区出现尿路症状的患者，泌尿生殖道蛔虫病仍应作为鉴别诊断的考虑因素。在资源有限的环境中，基本实验室技术在识别不常见的感染病因方面继续发挥关键作用。
