Lesson of the week: Subjective change in ejaculate as symptom of infection with Schistosoma haematobium in travellers

Genital manifestations of tropical diseases

“…29 MacKenna et al reported how seven men from New Zealand attended a sexual health clinic in Christchurch complaining of either yellow discoloration (three cases), reduction in semen volume (two cases), or consistency (two cases). 30 All the men had swum in Lake Malawi while travelling in Africa. Treatment with single dose praziquantel led to recovery in all cases.…”

Hematospermia Due to Schistosome Infection in Travelers

“…It is important to note that hematospermia is only one alteration in semen quality associated with male genital schistosomiasis. Other changes include yellow (rather than red or brownish) discoloration and reduction in viscosity to a "watery" consistency [2,5,6], and these symptoms may be more common than is hematospermia.…”

“…Subjective change in semen quality was a relatively common presentation among a series of returned travelers with schistosomiasis in New Zealand, being present in 7 of 13 males [2,5]. All 7 had swum in Lake Malawi in southern Africa during the preceding 12 months, were infected with Schistosoma haematobium, and responded to treatment with praziquantel.…”

Disorders of ejaculation: congenital, acquired and functional

“…Schistosomiasis is endemic in large parts of Africa and is seen with increasing frequency in tourists returning from Africa who have contracted the disease whilst enjoying water sports; Lake Malawi has acquired an evil reputation in this respect. The disease may present with haemospermia [ 25], and fibrosis and calcification may lead to genital obstruction. Genito‐urinary tuberculosis can cause great damage to the male reproductive tracts, and as healing occurs with calcification, the lesions may be irreparable, in the author’s experience.…”