Strongyloides and other strange critturs...

Hello Microbiologists!

Anyone know anything about collecting for strongyloides? Does it have to be a 24-hour urine or is it just a regular urine collection??

Thanks....

[flowerchild]

I believe you'll need a stool sample. Strongyloides are found in the intestinal tract. I suppose some could disseminate to other areas but I've not heard of a urine test for Strongyloides. A regular urine sample can be cultured to grow whatever is there.

I've learned in this feild that you can never say, it can't happen or it's always this way, b/c I know someone will come along and be the exception. Check with the lab and see what they need for the test.

[wolfox]

Strongyloides is a worm. You'll need a stool for Ova and parasites. If for some odd reason someone is looking for worms in urine, any sample would work. They can't be cultured and there is no reason to try and quantify how many would be passed in a 24 hour period.

[Sleepyeyes]

Thanks for your responses==I was confused because both Micro & the doc told me it was a urine sample when I called to ask, but every time I passed it on in report, it got switched around to a stool sample and never got collected.

Finally asked the doc to clarify the order, as he had the order sandwiched in with a "stool for O&P" type order. And I really don't care, long's the order gets taken care of by someone, anyone at this point.

[Gardengal]

I've never heard of a urine test for strongyloides. When I moved to Kentucky in the mid 90s for a few years I learned a little bit about these worms. New experience for me. We always did serial stool specimens.

We never really tested for them unless we saw an area of erythema at the upper buttock or lower back or abdomen with abdominal symtoms or actually saw wiggly 'things' in pulmonary secretions in the ET tube. Yuck! I remember when I learned about these critters.

I was walking past a room with a ventilator alarm going off for high pressure and the patient was obviously uncomfortably trying to cough to clear secretions. I went in to suction him and then planned to let the nurse know what was going on. I used the inline suction once and cleared gobs of secretions, waited a few seconds and planned to go down again when I saw some residual sputum in the tube wiggle. At firsti thought nothing of it, thinking the suction must be too high or that the patient movement caused the wiggle when I saw the sputum move again. This was a patient who had been admitted that weekend and I encountered this on a Monday before I learned all of the new admissions from the weekend.

I was dumbfounded. I turned the bright lights on in the room and bent down to peer at the ET tube. I got out the bedside flashlight to try to see this phenomena better. The nurse assigned to the patient walked in, looked at me and bit her lip. The patient was awake, and a bit responsive. The nurse motioned me from the room to instruct me on Strongyloides.

I'm from the Northeast and had never encountered these worms. I learned that in the mountains of Kentucky and Tennessee there was a population of men who brought these back from the Korean war, and although many people didn't know they had them that these worms took over when the patient was immunocompromised. They carried these worms, it was excreted in feces and picked up through the soles of bare feet of other people. Wow...The worms and larvae Lived in the digestive area and traveled up to the lungs when people were sick, but usually just went back down the pharynx swallowed back to digestive tract when the person was healthy-or just lay dormant for years.

we tested stool specimens when the symptoms were noted to define if the worms were strongyloides or hookworm which I guess got another treatment.

Luckily we didn't see these worms too often, but it sure was memorable. Okay, I digress....what a learning experience that was....Stool specimens is what we did though...and even though I've always been one who runs around bare foot in warm weather I now always wear at least flip flops or sandals.

[montroyal]

I had a pt that had a Strongyloidy Super infection in his lungs. Strongyloids enter thru the skin and into the blood stream. After entering the blood stream, they travel to the lungs were they develop. The patient then coughs up infected sputum and swallows it, thus entering the intestinal track. You can identify them by blood, sputum or stool. The ID MD thought my pt contracted them in Vietnam and had them in his system until dx in 1999. The patient spent 7 months on a vent from ARDS induced by the strongyloids. Curiuosly, the patient ran a no kill dog shelter and we regulary worm dogs and horses for strongyloids.

[Sleepyeyes]

Wow! fascinating info, folks! Thanks a bunch!

[dawngloves, BSN, RN]

Why oh why did I look at this thread???!!

[Agnus]

I thought it was a mispelling and was courious as to what it actually was. Yetch!

[NurseShell]

EEEE Yuck!! OK...good thing I already finished my dinner (onion soup - cooked onions resemble worms according to my 4 year-old who refused to eat the soup)!

I'll have to mentally file this information - just in case! Hope I NEVER need it! Bleck!