Strongyloides stercoralis: an example of unusual finding of larvae in urinary sediment

This report deals with the unusual finding of S. stercoralis in a urine sample. For the standard examination of urines our laboratory employs an automated system suited to determining chemical and physical parameters (Clinitek® Atlas™) as well as morphological parameters (Sysmex UF100 flow cytometer™). Samples showing inconsistencies between the two systems, the clinically significant or the unusual ones, need to be explained by analyzing the sediments after centrifugation. In June 2009 a urine sample from a girl approximately two-years-old appeared cloudy, and presented bacteriuria, proteinuria, and cylindruria. Microscopic examination indicated definite signs of faecal contamination by larvae of S. stercoralis, so that the sample was not suitable for further analysis.Additional data revealed the presence of hematological eosinophilia, while the parasitological stool examination confirmed the infestation. The physician, who was immediately informed, reported that the patient, originally from India, had recently been adopted and for this reason was submitted to the prescribed clinical screening.The relevance of this unexpected finding is that important clinical information can be retrieved even from materials not properly collected. By the present finding it is prudent to be wary of underestimating biological samples: sometimes one can get important, albeit unanticipated, clinical observations.