Schistosoma haematobium

Epidemiology

• endemic in freshwater (lakes, rivers) in many areas of sub-Saharan Africa

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

Clinical manifestations

• initially, flu-like symptoms (Katayama fever)
• painless gross hematuria (case report)
• dysuria worse toward the end of urination when bladder contracts maximally
• urinary frequency

Laboratory

• urine microscopy
  • gross hematuria
  • 3 separate samples on 3 separate days
    • 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
• Schistosoma haematobium serology

Complications

• left untreated, urinary schistosomiasis can cause
  • ureteric obstruction
  • secondary urinary tract infections
  • squamous-cell carcinoma of the bladder
  • renal failure

Management

• praziquantel single dose >= 8 weeks after last exposure

More general terms

• Schistosoma

Additional terms

• schistosomiasis (bilharziasis, Katayama fever)