Urinary schistosomiasis: an uncommon cause of gross hematuria in the industrialized countries

Abstract

Schistosomiasis is a parasitic disease that can cause significant illness in humans. While schistosomiasis is not found in the United States and other developed countries, 200 million people are infected worldwide. It is estimated that 400,000 infected persons immigrate to the United States and present to emergency departments with either acute or chronic schistosomiasis. Schistosomiasis can be expected to be seen with increasing frequency in the United States and other developed countries with the continuing influx of immigrants, as well as the return of travelers and soldiers from endemic areas. Although there are several etiologies of gross hematuria in children, schistosomiasis is an uncommon cause of gross hematuria in the industrialized world. The purpose of this report is to bring awareness to health-care providers in the United States and other developed countries of this uncommon cause of gross hematuria, as prompt diagnosis and treatment can result in quick resolution of symptoms.

The health of migrant children in Switzerland

“…High rates of tuberculosis and intestinal parasites found in paediatric asylum seekers in Geneva (Manzano and Suter 2002) reflect imported health needs linked to different prevalence of disease in countries of origin. International reports of tropical diseases (Moudgil and Kosut 2007), and of increased rates of certain infectious diseases (MacPherson et al 2006) in migrant children and a different pattern of congenital diseases [e.g., sickle cell disease in African children (Peters et al 2010)] illustrate, that paediatricians need to consider affections uncommon in central Europe, varying with the country of origin, in migrant children, even if some of these affections have not yet specifically been researched among immigrant children in Switzerland.…”

A rare case of hematuria

“…It is estimated that about 200 million people are infected, out of which 88 million are aged less than 15 years (4) . The peak of incidence and prevalence occurs in schoolaged children, between 8 and 12 years (5) .…”

“…About 10 to 12 weeks after the contact with the parasite, there is terminal or total hematuria, which may be accompanied by dysuria, pollakiuria, or fever (1) . Late manifestations (chronic schistosomiasis), in addition to hematuria, include proteinuria (many times as nephrotic manifestation), calcifications, renal cramps, hydronephrosis, urethral obstruction, renal failure and, possibly, bladder neoplasm (4) . Less frequently, there is the formation of immune complexes that contain specific parasite antigens that when deposited on the glomerular capillaries induce schistosomic glomerulopathy of variable degree.…”

“…The treatment of choice is praziquantel, a single dose of 40 mg/kg (8) . This therapy provides 80% cure rate and substantial reduction of number of parasites and egg excretion when cure is not effective (1,4) . The treatment with this antihelminthic eradicates the parasite and terminates the inflammatory response responsible for the chronic manifestations of the disease (5) .…”

Testicular schistosomiasis as differential diagnosis for testicular nodules: a case report

“…In an autopsy study in an endemic area in Brazil, testicular involvement was found in 3.2% of the schistosomiasis cases, indicating that these lesions are commonly subclinical (1) . Testicular involvement is attributed to the migration of eggs through venous channels between the internal spermatic and mesenteric veins (2) , inducing an immune response with granuloma formation and associated fi brotic changes (3) (4) . This lesion can mimic a malignant lesion presenting with painless small solid nodules.…”