Testicular Schistosomiasis Mimicking Malignancy in a Child: A Case Report

Ekenze, Sebastian O.; Modekwe, Victor O; Nzegwu, M.A.; Ekpemo, Samuel Chidi; Ezomike, Uchechukwu Obiora

doi:10.1093/tropej/fmv041

Cited by 11 publications

(13 citation statements)

References 9 publications

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“…In such endemic areas, people become infected as early in life as infants (35) and as they grow, repeated exposure through contact with infested lake water, results in re-infections and progressive development of chronic manifestations of schistosomiasis, including MGS in males (36,37). Despite some case reports on MGS being in young male children (38,39), most reports on MGS have been in adult males beyond adolescence, similar to our observation for the mean age of those with MGS being higher and significantly different to those without disease (34).…”

Section: Discussionmentioning

confidence: 99%

Male Genital Schistosomiasis Along the Shoreline of Lake Malawi: Baseline Prevalence and Associated Knowledge, Attitudes and Practices Among Local Fishermen in Mangochi District, Malawi

Kayuni

Alharbi

Makaula³

et al. 2021

Front. Public Health

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Male genital schistosomiasis (MGS) is an often-overlooked chronic consequence of urogenital schistosomiasis (UGS) associated with Schistosoma haematobium eggs and associated pathologies in the genital system of afflicted men. Despite the first formal description of MGS in 1911 by Madden, its epidemiology, diagnostic testing and case management of today are not well-described. However, since several interactions between MGS and the Human Immunodeficiency Virus (HIV) are known, there is renewed public health interest in MGS across sub-Saharan Africa (SSA). To shed new light upon MGS in Malawi, a longitudinal cohort study was set up among fishermen along the southern shoreline of Lake Malawi in Mangochi District, Malawi, to document its prevalence and assess mens' knowledge, attitudes and practices (KAP). After providing informed written consent, fishermen (n = 376) aged 18+ years (median age: 30 years, range: 18–70 years) were recruited and submitted urine and semen for point-of-care (POC) field and laboratory diagnostic parasitological tests. Individual questionnaires were administered to assess their KAP, with praziquantel (PZQ) treatment provided to all participants. Baseline prevalence of MGS (S. haematobium eggs in semen) was 10.4% (n = 114, median: 5.0 eggs per ml, range: 0.1–30.0) while for UGS (S. haematobium eggs in urine) was 17.1% (n = 210, median: 2.3 eggs per 10 ml, range: 0.1–186.0) and 3.8% were positive by POC circulating cathodic antigen (POC-CCA), indicative of a Schistosoma mansoni infection. Just under 10% of participants reported having experienced symptoms associated with MGS, namely genital or coital pain, or haemospermia. A total of 61.7% reported previous difficulties in accessing PZQ therapy, with 34.8% having received PZQ therapy before. There was a significant correlation between MGS infection and the frequency of fishing in a week (rho = −0.25, n = 100, p = 0.01). In conclusion, MGS is prevalent among local fishermen yet knowledge of the disease is poor. We therefore call for improved availability and accessibility to MGS diagnostics, PZQ treatment within ongoing control interventions. This will improve the lives and reproductive health of men, their partners and communities in this shoreline environment of Lake Malawi.

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Section: Discussionmentioning

confidence: 99%

Male Genital Schistosomiasis Along the Shoreline of Lake Malawi: Baseline Prevalence and Associated Knowledge, Attitudes and Practices Among Local Fishermen in Mangochi District, Malawi

Kayuni

Alharbi

Makaula³

et al. 2021

Front. Public Health

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“…In endemic areas it is fundamental to maintain a high degree of suspicion of testicular schistosomiasis as a differential diagnosis of testicular tumors in boys or adult males with a testicular mass 20,25 . The indication of radical orchiectomy should be carefully reviewed to avoid unnecessary invasive surgeries, especially in patients of reproductive age.…”

Section: Discussionmentioning

confidence: 99%

Ectopic forms of schistosomiasis mansoni in the second macroregion of Alagoas: case series report and review of the literature

Lima

Oliveira

Silva

et al. 2017

Rev. Soc. Bras. Med. Trop.

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Introduction: Ectopic forms of schistosomiasis are those in which the parasitic element is localized outside the portal system, the natural habitat of the helminth. Although the prevalence rates of schistosomiasis are high in Brazil, clinical and epidemiological data on ectopic forms of the disease are still scarce. Methods: Cross-sectional, retrospective and descriptive epidemiological study in which cases with a confirmed histopathological diagnosis of an ectopic form of schistosomiasis were analyzed. The cases were selected from a database of the anatomic pathology files of a referral center. Results: Of the 21 cases identified, seven affected the female genital tract and five the male genital tract; four cases were identified in the peritoneum; two cases involved lymph nodes and two involved adipose tissue; and renal involvement was detected in one case. Conclusions: The lack of knowledge of the clinical presentation of ectopic forms of schistosomiasis makes the early identification and treatment of this form difficult, with direct implications in the reduction of morbidity and mortality in endemic areas.

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“…The main findings reported in patients who have traveled or lived in schistosomiasis endemic areas are swelling of the scrotum and other genital organs, dilatation, and calcification of the prostate and seminal vesicles, haemospermia, hydrocele, changes in semen/ejaculate, infertility, and urethral discharge [ 7 , 13 ]. Case reports have mentioned the presence of S. haematobium or S. mansoni eggs in male genital organs and semen of some young and adult patients [ 14 – 24 ]. Variation in the levels of sex hormones was also reported in some male patients with S. haematobium and/or S. mansoni [ 25 – 29 ].…”

Section: Introductionmentioning

confidence: 99%

Reduction of testosterone levels in Schistosoma haematobium- or Schistosoma mansoni-infected men: a cross-sectional study in two schistosomiasis-endemic areas of the Adamawa region of Cameroon

et al. 2022

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Background The incidence of schistosomiasis‐induced male reproductive dysfunction and infertility is probably underestimated compared to female genital schistosomiasis. This study aimed to investigate the impact of Schistosoma haematobium or S. mansoni infection on the reproductive function of men of reproductive age in Tibati and Wouldé, two endemic schistosomiasis areas in the Adamawa region of Cameroon. Methods A total of 89 men of reproductive age (range 14–56 years) from two localities were enrolled in the study, with 51 in Tibati and 38 in Wouldé. Each participant was submitted to a questionnaire to document data on sociodemographic and stream contact behaviors. A medical examination was performed to measure the testes’ circumference and evaluate genital tract pathologies. Stool and urine samples were collected and screened for the presence of S. haematobium or S. mansoni ova. Blood serum was used to assess the levels of transaminases and testosterone. Results Schistosoma haematobium was present only in Tibati, with a prevalence of 31.37%. The S. mansoni prevalence was 3.92% at Tibati and 44.71% at Wouldé. The intensity of infection was 22.12 ± 9.57 eggs/10 mL for S. haematobium and 128.10 ± 3.76 epg for S. mansoni. Serum transaminase activity and the mean testicular circumference of Schistosoma-positive individuals were close to Schistosoma-negative individuals. However, the testes size was more prominent in S. mansoni-positive individuals than in S. haematobium-positive individuals (P < 0.05). The serum testosterone levels of S. haematobium- and S. mansoni-positive men were significantly reduced by 56.07% (P < 0.001) and 51.94% (P < 0.01), respectively, in comparison to those of Schistosoma-negative men. A significant and negative correlation was established between schistosomiasis and the low serum testosterone level. Male genital tract pathologies such as scrotal abnormalities, varicocele, nodular epididymis, inguinal hernia, and hydrocele were recorded in both Schistosoma-positive and Schistosoma-negative men. However, no significant link was established between schistosomiasis infection and these pathologies. Conclusion These results demonstrated that infection with S. haematobium or S. mansoni is associated with low production of the reproductive hormone testosterone and may be a significant cause of male infertility.

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Testicular Schistosomiasis Mimicking Malignancy in a Child: A Case Report

Cited by 11 publications

References 9 publications

Male Genital Schistosomiasis Along the Shoreline of Lake Malawi: Baseline Prevalence and Associated Knowledge, Attitudes and Practices Among Local Fishermen in Mangochi District, Malawi

Male Genital Schistosomiasis Along the Shoreline of Lake Malawi: Baseline Prevalence and Associated Knowledge, Attitudes and Practices Among Local Fishermen in Mangochi District, Malawi

Ectopic forms of schistosomiasis mansoni in the second macroregion of Alagoas: case series report and review of the literature

Reduction of testosterone levels in Schistosoma haematobium- or Schistosoma mansoni-infected men: a cross-sectional study in two schistosomiasis-endemic areas of the Adamawa region of Cameroon

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