Expert: Florence M Rollwagen - 6/8/2008

Question
Hi, I was hoping you could shed some light on a worm I found in the toilet.  It looked like a leech with a D type Cross section and possible suckers...maybe.  I don't want to jump to conclusions but I'm worried about parasitic infection.

I, at first, mistook the worm/leech/slug for a leaf but then it moved.  It looked to be anywhere from 1/2 inch when bunched to 2 inches in length when extended.  I could not find a picture of it online, but only a message board with a similar problem being discussed.

We do have well water and we just moved in.  Any help of identifying it would be greatly appreciated.

Thanks,
Nik

Answer
Hi Nik, and thanks for your interesting question.  There are some possibilities for the organism you described, but I will need more information.

First, do you think that the worm was in a bowel movement?  Did it just appear in the toilet without any “contributions” by a family member?

Second, where do you live?  Are you or a family member from another country, or did you travel outside the US recently?

It is important that if you think you are infected with this worm/leech, you should see a doctor right away.

Now for some information:

First, it’s probably not a leech, since they are not in the intestine, but live on the skin.   You would know if you had a leech infection.

Second, there are a number of intestinal worms that are about the right size.  Here is a website that discusses them:

http://www3.niaid.nih.gov/healthscience/healthtopics/parasiticroundworm/default....

Whipworm and Ascaris can be the right size, and can occur in the US (which is why I asked you where you lived).  

Strongyloides, right size, but not in USA.

Intestinal flatworms, such as tapeworm is a possibility, since segments can break off from the head, which lives in the intestine.


There is also an intestinal fluke called Fasciolopsis buski, which can be found in Asia.

On the other hand, since you say this is a new house, presumably with a new toilet/septic system/well, that the worm could have been trapped there when construction ended.  If this is an environmental worm, not a parasitic worm, there’s NO way it can be identified without a picture.  Perhaps it fell off your clothing in the bathroom?

Thanks, and write back with more information.

FM Rollwagen, PhD