Bladder schistosomiasis in Italy: A case report

Abstract

Introduction: Human schistosomiasis is a snail-borne disease caused by parasitic blood-dwelling flukes. A long-term infection can lead to the risk of liver damage, kidney failure, infertility, or bladder cancer. The most common sign is hematuria with the blood first seen in the terminal urine, but in severe cases the whole urine sample can be dark colored. We analyze the case of a healthy African child living in Italy since birth, harboring a hidden debilitating disease that was picked up during ultrasonography. Case Report: A 11-year-old African child was admitted to our emergency department with macroscopic hematuria, dysuria, and frequency for 2 months. Ultrasonography revealed a solid mass involving bladder’s right wall. Non-contrast and contrast-enhanced scans of computerized tomography showed a mass of 45 mm x 15 mm on the right bladder wall. A bipolar transurethral resection of bladder was performed. The pathological examination showed findings consistent with Schistosoma haematobium. Discussion: The clinical manifestations of schistosomiasis depend on the inflammatory response to the parasitic infection. In particular, it can manifest in the bladder as painless dysuria, urinary incontinence and urinary frequency, hematuria, or even urinary retention if the trigone is involved. Utilization of ultrasonography for diagnostic evaluation of schistosomiasis is mandatory. For treatment, the World Health Organization recommends praziquantel which has an efficacy of up to 90%.

Diagnosis and management of complicated urogenital schistosomiasis: a systematic review of the literature

“…In several reports [ n = 7], patients underwent invasive procedures and were also found to have a positive serology for S. haematobium [ 85 , 91 , 92 , 105 , 137 , 139 , 149 ]. On the contrary, in several reports [ n = 11], eggs were not present in the urine of patients with chronic schistosomiasis [ 92 , 98 , 100 , 102 , 103 , 106 , 126 , 134 , 137 , 139 , 140 ]. This is a known problem, as many of the pathologic manifestations in cUGS depend from chronic inflammation due to the formation of granulomas around eggs, rather than the continuous secretion of eggs from live parasites.…”