Biomédica 2018;38:13-8 First report of Dioctophyma renale in Colombia

doi: https://doi.org/10.7705/biomedica.v38i4.4042

CASE PRESENTATION

First report of Dioctophyma renale

(Nematoda, Dioctophymatidae) in Colombia
Ángel A. Flórez1, James Russo2, Nelson Uribe3
1
Facultad de Ciencias Exactas, Naturales y Agropecuarias, Programa de Medicina Veterinaria, Laboratorio de

Parasitología, Universidad de Santander, Bucaramanga, Colombia
2
Escuela de Medicina Veterinaria y Zootecnia, Instituto Universitario de la Paz (UNIPAZ), Barrancabermeja,

Colombia
3
Línea de Parasitología Humana y Veterinaria, Grupo de Investigación en Inmunología y Epidemiología

Molecular (GIEM), Facultad de Salud, Universidad Industrial de Santander, Bucaramanga, Colombia

Dioctophymosis is a zoonotic parasitic disease caused by Dioctophyma renale (Goeze, 1782). It is

distributed worldwide and it affects a large number of wild and domestic mammals.
Here we report the first confirmed case of canine dioctophymosis in Colombia. The animal was found
dead in the streets of the municipality of Yondó, Antioquia, and its dead body was taken to the Instituto
Universitario de la Paz (UNIPAZ) to carry out a necropsy.
A parasite worm was found in the right kidney and sent for identification to the Laboratorio de
Parasitología of the Universidad de Santander (UDES). The specimen was identified as a male of D.
renale upon observing the typical oval and transversely elongated bell-shaped bursa copulatrix with a
spicule and no rays. Another important factor to confirm the diagnosis was the anatomical location in
the kidney. This is the first time D. renale is reported in a stray dog in Colombia.
Key words: Dioctophymatoidea; Enoplida infections; case studies; Colombia.
doi: https://doi.org/10.7705/biomedica.v38i4.4042
Primer reporte de Dioctophyma renale (Nematoda, Dioctophymatidae) en Colombia
La dioctofimosis es una enfermedad parasitaria zoonótica causada por Dioctophyma renale (Goeze,
1782), de amplia distribución mundial, que afecta a un gran número de mamíferos silvestres y domésticos.
Se reporta el primer caso de dioctofimosis canina en Colombia. El animal fue encontrado muerto en
las calles del municipio de Yondó, Antioquia. Su cadáver fue llevado al Instituto Universitario de la Paz
(UNIPAZ) donde se practicó la necropsia.
En el riñón derecho se encontró un parásito, el cual fue enviado al Laboratorio de Parasitología de
la Universidad de Santander para su identificación. El espécimen se identificó como un macho de D.
renale por la típica bursa copulatriz oval y alargada transversalmente en forma de campana, sin rayos y
con una espícula. Otro factor importante para confirmar el diagnóstico fue la ubicación anatómica en el
riñón. Se reporta por primera vez la presencia de D. renale en un perro mestizo callejero en Colombia.
Palabras clave: Dioctophymatoidea; infecciones por Enoplida; estudios de casos; Colombia.
doi: https://doi.org/10.7705/biomedica.v38i4.4042

The nematode Dioctophyma renale (Goeze, 1782) world, with the possible exception of Africa and
belongs to the order Enoplida, family Dioctophy- the Australian continent. In America, it has been
matidae (1); it can measure up to 100 cm long and reported in Argentina, Brazil, Canada, the United
1.2 cm in diameter (2,3). It is commonly called giant States, Paraguay and Uruguay (8).
kidney worm and is one of the largest nematodes
which parasitizes vertebrates. Corresponding author:
Ángel A. Flórez, Laboratorio de Parasitología, campus
This nematode has been reported to infect domestic universitario Lagos del Cacique, Universidad de Santander,
carnivorous and wild animals such as dogs, foxes, Bucaramanga, Colombia
minks, coyotes, ferrets, otters, cats, pigs, horses, Teléfono: (577) 651 6500, extensión1395
cattle, and even humans (4-7). The parasitism it angelflorezmvz@hotmail.com
causes has spread throughout many parts of the Received: 24/08/17; accepted: 21/03/18

Author’s contributions:
All authors contributed to the identification of the parasite, the discussion, the literature review and the drafting of the manuscript.

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Flórez ÁA, Russo J, Uribe N Biomédica 2018;38:13-8

In the literature review we carried out for diocto- The ectopic locations of the parasite in the liver,
phymosis in Colombia, we found only one study in stomach, groin region, and mammary gland differ-
a Neotropical otter population (Lontra longicaudis) entiate the clinical presentation, as well as the num-
that reports eggs with characteristics similar to D. ber of parasites in the definitive host (13,16-18).
renale, but no adult parasites were reported (9). The importance of these parasites for public health
Dioctophyma renale is commonly described in resides in their zoonotic potential demonstrated by
dogs. Brazil and Argentina are the countries with the report of several human clinical cases (8,39-43).
the largest number of reported cases in mammals Dioctophymosis is a zoonotic disease in which
(5,10). In Brazil, cases have been reported in humans can be the definitive host, although the
several states, including Rio Grande do Sul (3,11- location of the parasite in the kidney is not the
20). Similarly, the canine dioctophymosis has been most frequent feature, as the peritoneum and the
reported in various regions of Argentina (10,21-26) skin are the most frequent locations in humans
and Uruguay (27,28). (38-42). Risk factors for human infection include a
The life cycle of D. renale is indirect and it may high prevalence of infected canines, a high level of
involve different types of hosts until the parasite surface contamination, the use of rivers as a means
reaches maturity. The dog is defined as the defini- of transportation, recreation and food fishing (fish,
tive host (11,29). The aquatic annelid Lumbriculus frogs, and eels) (10).
variegatus is the specific intermediary host and fish Here we report the first case of D. renale in
from freshwater and Chaunus ictericus (Bufonidae) Colombia detected in the necropsy of a dog found
are considered paratenic hosts (13,29,30). The in the municipality of Yondó, Antioquia, located
not-segmented egg is ingested by the intermediary near the Magdalena river where the dog possibly
host, hatches on the inside and the larva moves consumed food contaminated with the parasite.
to reach the third stage that infects the definitive Our report describes the lesions found in the dog
host or the paratenic host. The definitive hosts are and discusses how it could have been infected with
infected by ingesting the intermediary host or the this important nematode not previously reported in
paratenic host. The third stage larva penetrates the country.
the wall of the stomach or duodenum, and then
Case presentation
it migrates through the liver and peritoneal cavity
until it reaches the kidney, predominantly the right In August, 2015, the body of a dead dog found in
one, but some parasites stay in the peritoneal the streets of the municipality of Yondó (Antioquia)
cavity (8,31-33). However, the parasite has also was taken to the Instituto Universitario de la Paz to
been found in the left kidney, the abdominal cavity, carry out a necropsy. The dog was a male mongrel
the thoracic cavity, the ureters, the bladder and the about 8 years old and its weight was 10 kg. A
subcutaneous tissue of dogs and other definitive parasite was found in its right kidney and was sent
hosts (11,13,34-36). to the Laboratorio de Parasitología of the University
of Santander (UDES) for identification.
Normally the infection in dogs is subclinical (11,34),
but the affected animals can present compressive Materials and methods
atrophy of the parenchyma, dilation of the renal A complete post-mortem examination was per-
pelvis, and ureteral obstruction. The most striking formed for teaching purposes, giving special
lesion is the progressive destruction of the renal attention to the thoracic and abdominal cavities.
parenchyma, which, in the most severe cases, can The parasite was preserved in alcohol and sent to
reach a stage where only a thin capsule contains the Laboratorio de Parasitología at the Universidad
the parasite and hemorrhagic exudate (37,38). de Santander (UDES) in Bucaramanga.
The clinical presentation of dioctophymosis can be To identify the parasite, the morphological charac-
initially asymptomatic because the non-infected teristics of the external genital structures of the
kidney is usually capable of assuming the functions genus, as well as the size and color of the nematode
of the infected one. Individuals typically present and its anatomical location, were taken into consi-
symptoms including renal colic, hematuria, and deration (44,45). A definitive taxonomic key for the
pyuria. If the parasite migrates to the ureter and the identification of this species is the presence in males
urethra, it blocks the flow of urine, which can lead of a bell-shaped copulatory bursa with no rays and
to death by uremia and anuria. a spicule measuring 0.5 to 0.6 cm long (46).

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Biomédica 2018;38:13-8 First report of Dioctophyma renale in Colombia

Discussion
The macroscopic features observed at the necropsy,
such as the location of the parasite in the kidney
and its red color, led to the identification of D. renale
in almost a definitive way because of its large size,
which makes this procedure an important diagnosis
method. The final identification of the parasite as
a male of D. renale was based on its morphologi-
cal characteristics, mainly the typical bell-shaped
bursa copulatrix with no rays and a protruding
spicule of 0.5 to 0.6 cm in length (3,30,35,47,48),
which are characteristic of this species (figure 1).
The nematode measured 17 cm in length and 3
mm in diameter (figure 2). During the necropsy, no Figure 1. The large bell-shaped copulatrix bursa with a spicule
significant macroscopic lesions were observed. that protrudes and no rays, characteristic of Dioctophyma renale

In the literature review we carried out on diocto-

phymosis in Colombia, we found only one study
in a Neotropical otter population (L. longicaudis).
Only eggs with characteristics similar to D. renale
were reported, so there was no certainty about
the presence of adult parasites or about eggs
effectively corresponding to the parasite (9).
The dead body of the dog did not present signifi-
cant lesions, and it did not show signs that it had
been hit by a car either. The parenchyma of the
right kidney was completely destroyed and only the
organ capsule was left (figure 3). Figure 2. The parasite measured 17 cm in length and 3 mm in
diameter; a reddish coloration was observed.
In the necropsy, a male specimen of D. renale
was found in the right kidney of the animal. This
anatomical location of the specimen coincided
with the majority of reports of this parasite
(3,11,12,27,37,49-51) and is related to the anatom-
ical position of this organ in front of the duodenum,
where D. renale frequently leaves the intestine
during its migratory route (52). The location of
the parasite in the left kidney is less frequent,
as it occurs when it crosses the stomach in the
greater curvature or develops a cyst around the
liver associated with its migration through the lower
curvature of the stomach (11).
In a retrospective study of 16 cases of D. renale
infection in dogs, all diagnoses were based on
necropsy findings (11). In most of the cases, the
Figure 3. Parenchyma of the right kidney completely destroyed
parasitic infection by D. renale in these animals by the parasite after eating the insides of the kidney leaving only
was found during the necropsy. Clinical diagnosis the renal capsule of the organ
is difficult given that signs and symptoms have no
specificity and many individuals are asymptomatic
of the abdominal cavity (38). In addition, in cases
(11,34,37,38,53).
where there is a loss of renal parenchyma with
In some cases, canine dioctophymosis can be concomitant hypertrophy of the non-parasitized
diagnosed by parasitological examination of the kidney, the diagnosis can be done by performing
urine (34,35), or during an exploratory laparotomy an ultrasound (Oliveira LL, Attallah FA, Santos CL,

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Flórez ÁA, Russo J, Uribe N Biomédica 2018;38:13-8

Wakofs TN, Rodrigues MC, Santos AE. O uso da Santander (UIS) and to Professor Jesús Antonio
ultrassonografia para o diagnóstico de Dioctophyma Betancourt-Echeverri for his support on identifying
renale em ca˜o–relato de caso. In: Annals V Con- the parasite under study.
ferência Sul-americana de Medicina Veterinária.
Conflicts of interest
Rio de Janeiro, Brazil, 2005) or a radiograph (54).
None to declare
In the case we report, only one adult parasite was
found in the dog’s right kidney. However, an unu- Funding
sual case of canine dioctophymosis was reported
Universidad de Santander (UDES)
in Brazil, in which 28 worms of both sexes were
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