Dioctophyme renale
| Dioctophyme renale | |
|---|---|
| Scientific classification | |
| Kingdom: | Animalia |
| Phylum: | Nematoda |
| Class: | Secernentea |
| Order: | Ascaridida |
| Family: | Dioctophymatidae |
| Genus: | Dioctophyme |
| Species: | D. renale |
| Binomial name | |
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Dioctophyme renale (Goeze, 1782) |
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Dioctophyme renale, commonly referred to as the "giant kidney worm" is a parasitic roundworm whose mature form is found in the kidneys of mammals. D. renale is distributed worldwide, but is less common in Africa and Oceania. It affects fish eating mammals, particularly mink and dogs. Human infestation is rare, but results in destruction of the kidneys. Upon diagnosis through tissue sampling, the only treatment is surgical excision.
Dioctophymosis, giant kidney worm, kidney worm infection, Dioctophyme renalis infection
Dioctophyme renale was discovered in 1583. Almost two centuries later, in 1782, Johann Goeze first described D. renale upon discovering the worms in a dog kidney. The family Dioctophymidae has only one genus (Dioctophyme), and the name of the genus was in contention (with the possibility of being Dioctophyma) for two hundred years. The issue was finally resolved by the International Commission on Zoological Nomenclature in 1989.
In 2003, D. renale eggs were discovered in six human coprolites in the neolithic site Arbon-Bleiche 3, Switzerland. This location is located near a lake, which likely provided early humans with access to freshwater fish and frogs. The samples were dated from 3,384-3,370 BC, and is evidence that the prevalence of this infection was higher in early human history (before full understanding of proper cooking techniques).
Individuals with Dioctophyme renalis infection typically present with unspecific symptoms including hematuria (blood in urine), nephritis, loin pain, renal enlargement, and/or renal colic (intermittent pain in the kidney area), which may result from the rare migration of worms through ureters. In some cases the fibrosis occurring after parasite infection is an incidental finding in ultrasound or CT scan, mimicking renal cancer, leading to radical nephrectomy.
Adult worms typically only infect one kidney. The kidney is destroyed because of fibrosis, the development of excess fibrous connective tissue. Global renal dysfunction is typically limited because the non-infected kidney is usually capable of assuming the increased work. However, parenchymal inflammation can lead to death in extreme circumstances.
Adult Dioctophyme renale inhabit the kidney (typically the right kidney). Females produce eggs which are passed in urine. In aquatic environments, eggs embryonate after 15–100 days. These eggs are ingested by an aquatic oligochaete, hatch, penetrate blood vessels, and develop into a stage three larvae. A paratenic host may then ingest the oligochaete. The oligochaete or paratenic host is then eaten by a definitive host, wherein juveniles penetrate intestinal lining and migrate to the liver. After maturing for approximately 50 days, the juveniles then migrate to the kidneys (typically the right kidney). Upon maturation, D. renale can survive for five years.
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