Schistosomiasis-A Disobedient Ureter, a Disobedient Diagnosis

Journal of Endourology Case Reports
Pallavi Olivia PalSarah Logan

Abstract

Background: Schistosomiasis is rare in western countries, but remains a potentially serious disease. It is known to result in severe urogenital complications; prompt diagnosis can therefore significantly affect outcomes. Case Presentation: We report the case of a 41-year-old male with pleuritic chest pain and visible hematuria who had emigrated from Zimbabwe to the United Kingdom 20 years previously. CT imaging revealed a hydronephrotic right pelvicaliceal system, with a dilated ureter to its distal portion. Preliminary tests for schistosomiasis, including terminal urine microscopy and serology, were negative. An initial ureteroscopy was challenging owing to a tight ureteral stricture such that a retrograde stent insertion and not ureteroscopic visualization or biopsy was carried out. A relook ureteroscopy after 6 weeks revealed a dense distal ureteral stricture, biopsies were taken, the stricture was ablated with LASER, and a retrograde stent was placed. Microscopic examination of the biopsies confirmed Schistosomiasis haematobium. Treatment consisted of a divided dose of praziquantel and a reducing dose of steroids. At a third look ureteroscopy the stricture was ablated with LASER again, and the stent was removed. Subseque...Continue Reading

References

Jul 28, 2004·Parasitology Today·L SavioliK Behbehani
Mar 8, 2006·European Urology·Karl-Horst BichlerPeter Tenke
Jan 13, 2015·Transactions of the Royal Society of Tropical Medicine and Hygiene·Cordelia E M ColtartChristopher J M Whitty

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Citations

Aug 29, 2021·Pathogens·Andrea CiminiOrazio Schillaci

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Methods Mentioned

BETA
biopsy

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