UNIDENTIFIED LARV/E OF SOME DIPTEROUS INSECT DE- 

 VELOPING IN THE DEEP URETHRA AND BLAD- 

 DER OF MAN PRODUCING SEVERE 

 ABDOMINAL SYMPTOMS. 1 



By G. P. Trible. 2 



Francisco Jose, a civilian employed at the United States naval station, 

 Oiongapo, Philippine Islands, reported to the sick quarters for treatment 

 February 10, 1910, complaining of abdominal cramps. During that 

 night the pain subsided and he slept well. The following morning the 

 abdominal pain became very severe, accompanied with nausea, vomiting, 

 and general abdominal rigidity. His bowels were open ; urine was 

 voided at 8 o'clock in the morning. 



The patient was transferred to the IT. S. steamer Relief at 3 o'clock 

 in the afternoon. Upon admission his temperature registered 36.3° and 

 general abdominal rigidity which was board-like over the bladder was 

 present. Pain and tenderness were felt over the bladder and stomach. 



A sterile, hard-rubber catheter was passed into the bladder, meeting 

 some yielding obstruction in the deep urethra. About 150 cubic centi- 

 meters of clear urine were withdrawn. This contained numerous, actively 

 motile, larvaB-like organisms. An examination of the fasces was negative. 

 The urethra and bladder were then thoroughly irrigated with potassium 

 permanganate and boric acid solutions. At 7 o'clock in the evening 

 the symptoms had subsided to those of a mild case of acute cystitis. Two 

 hundred cubic centimeters of urine were withdrawn, containing a few 

 dead, but no living organisms. The patient complained of exquisite 

 tenderness on passing the catheter through the deep urethra and sphincter. 



Two days later all signs of bladder irritation had disappeared, the urine 

 passed was clear and free from larvee. The patient was discharged and 

 returned to duty February 14, 1910. 



In this case there was no history of disease of the urethra or rectum 

 prior to the onset of the symptoms on February 11. The anterior urethra 

 was normal. The eggs evidently were deposited and developed in the 

 deep urethra, the larva? passing through the sphincter of the bladder and 

 causing acute inflammation of the bladder. 



1 Read at the First Biennial Meeting of the Far Eastern Association of Tropical 

 Medicine, held at Manila, March 7, 1910. 



2 Assistant surgeon, United States Navy. 



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