ESPN 53rd Annual Meeting

ESPN 2021


 
PERSISTENT HEMATURIA DUE TO SCHISTOSOMA HAEMATOBIUM. AN IMPORTED PATHOLOGY WITH DIFFICULT TREATMENT
ELENA CODINA SAMPERA 1 PEDRO ARANGO SANCHO 1 YOLANDA CALZADA BAÑOS 1 VÍCTOR LÓPEZ-BAEZ 1 ANA VINUESA JACA 1 LINA CATHERINE HERNÁNDEZ ZÚÑIGA 1 ÁLVARO MADRID ARIAS 1

1- HOSPITAL SANT JOAN DE DéU
 
Abstract:

OBJECTIVES: Bladder schistosomiasis is a rare cause of hematuria. We present three patients with different evolution, highlighting the importance of this pathology in the differential diagnosis of persistent hematuria.

METHODS:Case 1: A 9-year-old male from Mali with macrohematuria for 4 months. The physical examination and the renal ultrasound were normal with a negative urine culture. The urine test showed hematuria, leukocyturia and proteinuria. Blood tests just showed anemia. In the microbiological urine study, Schistosoma haematobium (SH) eggs were observed. He received three doses of Praziquantel. One month later, he still had microhematuria and SH eggs in the urine, so another praziquantel cycle was repeated.
Case 2: A 10-year-old male from Guinea. He presented intermittent episodes of macrohematuria with hypogastric pain. She received antibiotic therapy for suspected acute cystitis. He had hematuria, leukocyturia, and moderate proteinuria. Renal ultrasound showed a bladder with thickened walls and inflammatory appearance, compatible with cystitis and distal ureteritis. The microbiological study showed eggs of SH. He received three doses of Praziquantel. 3 weeks later he had a normal urine, but SH eggs persisted, so the treatment was repeated.
Case 3: A 11-year-old male from Senegal. In Spain for 3 months. He presented a 1-month of macroscopic non-painful hematuria. The urine test showed proteinuria in the nephrotic range, hematuria and leukocyturia. The renal ultrasound showed a thinned bladder without calcifications. In the urine we found SH eggs. He received three doses of praziquantel with urinary normalization in 2 weeks.
RESULTS AND CONCLUSIONS: SH has a special tropism for the perivesical plexuses. In chronically affected patients, the eggs may persist after treatment, requiring an other cycle of praziquantel at 4 weeks. If the clinic persists, we must rule out scar lesions or subsidiary granulomas of surgical resection.