Journal of Parasitic Diseases

, Volume 42, Issue 4, pp 608–615 | Cite as

Spectrum of parasitic infections in centrifuged urine sediments from a newly developed tertiary care centre in Central India

  • Ujjawal Khurana
  • Kaushik Majumdar
  • Neelkamal KapoorEmail author
  • Deepti Joshi
  • Garima Goel
  • Tanya Sharma
  • Debasis Biswas
Original Article


Detection of urinary parasites is relatively rare and incidental finding in routine urine examination. Common urinary parasitic infections as described in literature include Trichomonas, Schistosoma hematobium and Microfilaria. Trichomonas vaginalis is known to cause vaginitis and urethritis, and may be found in urine sediments. In this study, the spectrum of urinary parasitic infections that had been reported in the last one and a half year was evaluated, and point prevalence in this zone was estimated. Microbiologist opinion had been taken in the difficult cases. Out of the total centrifuged urine sediments examined, urinary parasitic infection was found in 33 cases. The calculated point prevalence is 0.39%. Most common parasitic infection reported was flagellates (27 cases: 25 T. vaginalis, 2 commensal flagellate closest to Chylomastix), followed by three cases showing eggs of Enterobius vermicularis, one case showing larvae of Strongyloides stercoralis and two cases of ciliate protozoa. One of the ciliate protozoa was Balantidium coli and the other one was Balantidium like ciliate morphologically closest to Chilodonella spp. Pyuria was found in 22 out of the 33 cases and hematuria in 17 out of 33 cases. A fairly wide morphological spectrum of parasites may be diagnosed through microscopic examination of centrifuged urine sediment. They may cause pyuria and haematuria, and morphological awareness helps in prompt and effective management in most cases.


Balantidium coli Enterobius vermicularis Protozoa Strongyloides stercoralis Trichomonas vaginalis Urine sediment 



The authors acknowledge the valuable contribution of Mr. Pradeep Kumar Gupta (M.Sc. Microbiology), Demonstrator, Department of Microbiology, AIIMS, Bhopal. The authors acknowledge the contribution of all the technical staffs and residents of Department of Pathology and Laboratory medicine, AIIMS, Bhopal.

Author contributions

UK: Collection of patient details, Digital Photography, literature review and writing up of manuscript. KM: Signing out of the reports, Assisting in literature review and writing up of manuscript. NK: Expert opinion and critical review of the manuscript. DJ: Expert opinion and critical review of the manuscript. GG: Signing out of the reports, Assisting in literature review. TS Collection of patient details, Digital Photography. DB: Expert opinion and critical review of the manuscript.

Compliance with ethical standards

Ethical approval

Yes; all investigations were done as part of the patients’ management protocol, and no patient was subjected to any procedures or investigations for the sake of this study. Approval from the competent authority of the institute has been taken.

Conflict of interest


Supplementary material

12639_2018_1043_MOESM1_ESM.mp4 (10.6 mb)
Video showing vase like ciliate with motility on ventral aspect (MP4 10868 kb)
12639_2018_1043_MOESM2_ESM.mp4 (7.2 mb)
Video of the urine sediment showing larva of strongyloides (MP4 7398 kb)


  1. Ahuja A, Das P, Durgapal P, Saini A, Dogra PN, Mathur SR et al (2012) Microfilaria in a patient of achylous hematuria: a rare finding in urine cytology. J Cytol 29:147–148CrossRefGoogle Scholar
  2. Avram E, Yakovlevitz M, Schachter A (1984) Cytologic detection of Enterobius vermicularis and Strongyloides stercoralis in routine cervicovaginal smears and urocytograms. Acta Cytol 28:468–470PubMedGoogle Scholar
  3. Babady NE, Awender E, Geller E, Miller T, Scheetz G, Arguello H et al (2011) Enterobius vermicularis in a 14-year-old girl’s eye. J Clin Microbiol 49:4369–4370CrossRefGoogle Scholar
  4. Bandyopadhyay A, Majumder K, Goswami BK (2013) Balantidium coli in urine sediment: report of a rare case presenting with hematuria. J Parasit Dis 37:283–285CrossRefGoogle Scholar
  5. Blake DR, Duggan A, Jaffe A (1999) Use of spun urine to enhance detection of Trichomonas vaginalis in adolescent women. Arch Pediatr Adolesc Med 153:1222–1225CrossRefGoogle Scholar
  6. Cheesebrough M (2009) District laboratory practice in tropical countries, 2nd edn. Cambridge University Press, New YorkGoogle Scholar
  7. Costache C, Bursasiu S, Filipas C, Colosi I (2011) A case of ciliate protozoa Colpoda spp. (Ciliata: Colpodidae) detected in human urine. Iran J Parasitol 6:99–104PubMedPubMedCentralGoogle Scholar
  8. Gardner WA, Culberson DE, Bennett BD (1986) Trichomonas vaginalis in the prostate gland. Arch Pathol Lab Med 110:430–432PubMedGoogle Scholar
  9. Kali A (2015) Schistosome infections: an Indian perspective. J Clin Diagn Res. CrossRefPubMedPubMedCentralGoogle Scholar
  10. Karuna T, Khadanga S (2014) A rare case of urinary balantidiasis in elderly renal failure patient. Trop Parasitol 4:47–49CrossRefGoogle Scholar
  11. Kaydos-Daniels SC, Miller WC, Hoffman I, Price MA, Martinson F, Chilongozi D et al (2004) The use of specimens from various genitourinary sites in men, to detect Trichomonas vaginalis infection. J Infect Dis 189:1926–1931CrossRefGoogle Scholar
  12. Majumdar K, Sakhuja P, Jain D, Singh M, Agarwal A (2014) Balantidium ascites: an incidental smile in a cytospin during workup for malignancy. Cytopathology 25:138–140CrossRefGoogle Scholar
  13. Mali BN, Joshi JV (1987) Vaginal parasitosis. An unusual finding in routine cervical smears. Acta Cytol 31:866–868PubMedGoogle Scholar
  14. Mc Pherson RA, Threatte GA, Pincus MR (2011) Basic examination of urine. In: Mc Pherson RA, Pincus MR (eds) Henry’s clinical diagnosis and management by laboratory methods, 22nd edn. Elsevier Saunders, New Delhi, pp 445–479CrossRefGoogle Scholar
  15. Mitra AK, Haldar DP (2004) First record of Chilodonella hexasticha (Kiernik, 1909) Kahl, 1931 (Ciliophora: Chilodonellidae) infesting a freshwater fish Nandus nandus (Hamilton) from Gangetic West Bengal, India. Anim Biol 54:111–118CrossRefGoogle Scholar
  16. Morenikeji OA, Azubike NC, Ige AO (2009) Prevalence of intestinal and vector-borne urinary parasites in communities in south-west Nigeria. J Vector borne Dis 46:164–167PubMedGoogle Scholar
  17. Murthy DA, Luthra UK, Sehgal K, Sodhani P (1994) Cytologic detection of Strongyloides stercoralis in routine cervicovaginal smear. A case report. Acta Cytol 38:223–225Google Scholar
  18. Ok UZ, Ertan P, Limoncu E, Ece A, Ozbakkaloglu B (1999) Relationship between pinworm and urinary tract infections in young girls. APMIS 107:474–476CrossRefGoogle Scholar
  19. Pasqualotto AC, Zborowski MF, dos Anjos M, Poloni JA, dos Santos AP, Torelly AP (2009) Strongyloides stercoralis in urine. Trans R Soc Trop Med Hyg 103:106–107CrossRefGoogle Scholar
  20. Patel B, Sharma T, Bhatt GC, Dhingra Bhan B (2015) Enterobius vermicularis: an unusual cause of recurrent urinary tract infection in a 7-year-old girl: case report and review of literature. Trop Doct 45:132–134CrossRefGoogle Scholar
  21. Pomajbikova K, Obornik M, Horak A, Petrzelkova KJ, Grim JN, Levecke B (2013) Novel insights into the diversity of Balantidium and Balantidium like cyst forming ciliates. PLoS Negl Trop Dis 7:e2140CrossRefGoogle Scholar
  22. Schuster FL, Ramirez-Avila L (2008) Current world status of Balantidium coli. Clin Microbiol Rev 21:626–638CrossRefGoogle Scholar
  23. Sorvillo F, Kerndt P (1998) Trichomonas vaginalis and amplification of HIV-I transmission. Lancet 351:213–214CrossRefGoogle Scholar
  24. Sutcliffe S, Neace C, Magnuson NS, Reeves R, Alderete JF (2012) Trichomoniasis, a common curable STI, and prostate carcinogenesis—a proposed molecular mechanism. PLoS Pathog 8:e1002801CrossRefGoogle Scholar
  25. Vankalakunti M, Kumar S, Nijhawan R (2008) Microfilariae in urine. Acta Cytol 52:639–640CrossRefGoogle Scholar
  26. Zahariou A, Karamoutli M, Papaionnaou P (2007) Enterobius vermicularis in the male urinary tract: a case report. J Med Case Rep 1:137CrossRefGoogle Scholar

Copyright information

© Indian Society for Parasitology 2018

Authors and Affiliations

  1. 1.Department of Pathology and Laboratory MedicineAll India Institute of Medical Sciences (AIIMS)BhopalIndia
  2. 2.Department of Pathology, Academic Block, Room No 323, Maulana Azad Medical CollegeG B Pant Institute of Postgraduate Medical Education and Research (GIPMER)New DelhiIndia
  3. 3.Department of MicrobiologyAll India Institute of Medical SciencesBhopalIndia

Personalised recommendations