From the Guidelines
If you see what appears to be a worm in your urine, you should collect a sample and seek immediate medical attention, as this could indicate a parasitic infection such as schistosomiasis, which requires proper diagnosis and treatment with antiparasitic medications like praziquantel 40 mg/kg 1. When considering the potential causes of a worm in urine, it's essential to prioritize the most likely and serious conditions, such as schistosomiasis, which can lead to complications like obstructive uropathy, bladder stones, and bacterial superinfection if left untreated 1. Some key points to consider in the diagnosis and management of such cases include:
- The prepatent period for schistosomiasis can range from 5 to 12 weeks, during which the infection may not be detectable through standard tests 1.
- Clinical presentation can vary from asymptomatic to symptoms like microscopic haematuria, proteinuria, dysuria, and haematospermia, with some cases presenting acutely as Katayama syndrome 1.
- Investigations should include serology and microscopy of nitrocellulose-filtered terminal urine, with midday collection of urine for microscopy increasing sensitivity, although serology may remain positive for many years after treatment 1.
- Treatment with praziquantel is recommended for light infections in travelers, with the dosage being 40 mg/kg, and heavy infections or those associated with complications may require further investigation and management 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Causes of Worms in Urine
- Worms in urine can be caused by a parasitic infection known as schistosomiasis, which is caused by the genus Schistosoma 2.
- The infection occurs through exposure to contaminated water in endemic regions 2.
Treatment Options
- Praziquantel (PZQ) is the current drug of choice for the treatment of urinary schistosomiasis in endemic areas 3, 4, 5, 6.
- Albendazole (ALB) is also used in the treatment of intestinal helminths infection and has been suggested as a potential treatment for urinary schistosomiasis 3.
- Metrifonate is another effective treatment for urinary schistosomiasis, although it requires multiple administrations and is operationally less convenient in community-based control programmes 4.
Efficacy of Treatment Options
- PZQ has been shown to have a higher cure rate (78.0%) compared to ALB (68.7%) in the treatment of urinary schistosomiasis 3.
- Metrifonate has been shown to be effective in reducing parasitological failure and egg reduction rates, with few adverse events reported 4.
- The efficacy of PZQ and other treatment options may vary depending on the severity of the infection and the presence of resistance 5, 6.
Resistance and Future Perspectives
- The potential for the development of resistance to PZQ has been reported in some endemic areas, which is a concern that should be constantly investigated in human populations 5, 6.
- New therapeutic perspectives, such as the use of PZQ in combination with other drugs or the development of new compounds, are being explored to address the issue of resistance 6.