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Schistosoma haematobium
Epidemiology:
- endemic in freshwater (lakes, rivers) in many areas of sub-Saharan Africa [1]
Pathology:
- urinary schistosomiasis occurs after the release of eggs by adult worms living in the bladder & pelvic venous plexus
- eggs penetrate the bladder wall & ureters, causing granulomas & fibrotic nodules [1]
Clinical manifestations:
- initially, flu-like symptoms (Katayama fever)
- painless gross hematuria (case report) [1]
- dysuria worse toward the end of urination when bladder contracts maximally [2]
- urinary frequency
Laboratory:
- urine microscopy
- gross hematuria
- 3 separate samples on 3 separate days [2]
- Schistosoma haematobium sheds more ova midday, so noon time sample best
- oval eggs ~110-170 um in length by 50-70 um in width with a terminal spine & transparent shell [1]
- Schistosoma haematobium serology
Complications:
- left untreated, urinary schistosomiasis can cause
- ureteric obstruction
- secondary urinary tract infections
- squamous-cell carcinoma of the bladder
- renal failure [1]
Management:
- praziquantel single dose >= 8 weeks after last exposure [1,2]
Related
schistosomiasis (bilharziasis, Katayama fever)
General
Schistosoma
Properties
KINGDOM: animal
PHYLUM: helminth
References
- Ganapathi L, Somers M
A Child with Gross Hematuria.
N Engl J Med 2015; 373:e11. August 27, 2015
PMID: 26308700
http://www.nejm.org/doi/full/10.1056/NEJMicm1410250
- NEJM Knowledge+ Nephrology/Urology