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Manciulli T, Marangoni D, Salas-Coronas J, Bocanegra C, Richter J, Gobbi F, Motta L, Minervini A, Bartoloni A, Zammarchi L. Diagnosis and management of complicated urogenital schistosomiasis: a systematic review of the literature. Infection 2023; 51:1185-1221. [PMID: 37466786 PMCID: PMC10545601 DOI: 10.1007/s15010-023-02060-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/31/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Currently, there are no standardized guidelines for the diagnosis or management of the complications of urogenital schistosomiasis (UGS). This systematic review of the literature aims to investigate the state of the art in reference to diagnostic approaches and the clinical management of this condition. METHODS A systematic review of literature published between January 1990 and January 2021 was conducted in the MEDLINE database, scoping for articles regarding diagnostic means or therapeutic options for the complications of UGS, namely obstructive uropathy, bladder cancer, abortion, ectopic pregnancy, infertility, kidney failure, urolithiasis and the need for invasive procedures. Relevant data were then extracted from the articles deemed eligible according to the inclusion criteria. MAIN RESULTS In total, 3052 articles were identified by the research query, of which 167 articles fulfilling inclusion criteria after title/abstract screening and full-text evaluation were included, 35% on both diagnostic and therapeutic aspects, and 51% on diagnosis and 14% on therapy. Ultrasound was the most frequently tool employed for the diagnosis of UGS complications showing a good performance. Concerning the management of hydronephrosis, the majority of available evidences came from community-based studies where universal treatment with praziquantel was used leading to decrease of prevalence of obstructive uropathy. Concerning studies on surgical procedures, laser endoureterotomy followed by stenting was mostly employed in adult patients leading to a crude cure rate of 60% (43 of 71 patients). In the case of severe hydronephrosis, surgery consisting of ureteral re-implantation showed excellent results with a crude cure rate of 98% (157 cured patients of 160 treated). Concerning bladder cancer, data on 93 patients with a clear diagnosis of UGS-related bladder were available reporting a variable and sometime combined approach based on disease stage. Available data on diagnosis and management of abortion, ectopic pregnancy, infertility, kidney failure, urolithiasis and the need for invasive procedures due to UGS are also presented. CONCLUSIONS The review produced a complete picture of the diagnostic and therapeutic options currently available for complicated UGS. These results can be useful both for guiding clinicians towards correct management and for tracing the direction of future research.
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Affiliation(s)
- Tommaso Manciulli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Davide Marangoni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Cristina Bocanegra
- Tropical Medicine and International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Joachim Richter
- Institute of Tropical Medicine and International Health, Charité Universitätsmedizin, Corporate Member of Free University and Humboldt University Berlin and Berlin Health Institute, Berlin, Germany
| | - Federico Gobbi
- Infectious-Tropical Diseases and Microbiology Department, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona, Italy
| | - Leonardo Motta
- Infectious-Tropical Diseases and Microbiology Department, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona, Italy
| | - Andrea Minervini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Department of Infectious and Tropical Diseases, Azienda Ospedaliero Universitaria Careggi, Largo Giovanni Alessandro Brambilla, 3, 50134, Florence, Italy
| | - Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
- Department of Infectious and Tropical Diseases, Azienda Ospedaliero Universitaria Careggi, Largo Giovanni Alessandro Brambilla, 3, 50134, Florence, Italy.
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Ido F, Ouedraogo A, Savadogo I, Hafing T, Ouattara S. Epididymal bilharzia simulating a testicular tumor: A case report. IDCases 2023; 32:e01770. [PMID: 37131488 PMCID: PMC10149191 DOI: 10.1016/j.idcr.2023.e01770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 05/04/2023] Open
Abstract
Bilharzia or schistosomiasis is a parasitic disease due to infestation by a hematophagous trematode of the genus Schistosoma. It is the second most frequent parasitic endemic in the world after malaria. The most frequent tissue infections are intestinal and genitourinary. Testicular localizations of schistosoma are very rare. When lesions become chronic, they present as non-specific masses, bilharziomas, posing enormous problems of differential diagnosis with other benign and malignant pathologies, which impacts management. We report a case of epididymal schistosomiasis in a 37 years old patient simulating a malignant tumor. This case allowed us to review the diagnostic difficulties of this rare localization and the challenges of management.
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Affiliation(s)
- F.A.H.A. Ido
- Department of Anatomy and Pathological Cytology CHU, Tengandogo, Ouagadougou, Burkina Faso
- Correspondence to: 11 BP 104 CMS Ouagadougou 01, Burkina Faso.
| | - A.S. Ouedraogo
- Department of Anatomy and Pathological Cytology CHU, Bogododgo, Ouagadougou, Burkina Faso
| | - I. Savadogo
- Department of Anatomy and Pathological Cytology CHU-R of Ouahigouya, Burkina Faso
| | - T. Hafing
- Department of Urology CHU, Tengandogo, Ouagadougou, Burkina Faso
| | - S. Ouattara
- Department of Anatomy and Pathological Cytology CHU, Tengandogo, Ouagadougou, Burkina Faso
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Jatsa HB, Femoe UM, Dongmo CN, Kamwa RIN, Fesuh BN, Tchuem Tchuente LA, Kamtchouing P. 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. BMC Infect Dis 2022; 22:230. [PMID: 35255836 PMCID: PMC8900354 DOI: 10.1186/s12879-022-07195-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/22/2022] [Indexed: 11/10/2022] Open
Abstract
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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Affiliation(s)
- Hermine Boukeng Jatsa
- Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, P.O. Box 812, Yaoundé, Cameroon. .,Centre for Schistosomiasis and Parasitology, P.O. Box 7244, Yaoundé, Cameroon.
| | - Ulrich Membe Femoe
- Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, P.O. Box 812, Yaoundé, Cameroon.,Centre for Schistosomiasis and Parasitology, P.O. Box 7244, Yaoundé, Cameroon
| | - Calvine Noumedem Dongmo
- Centre for Schistosomiasis and Parasitology, P.O. Box 7244, Yaoundé, Cameroon.,Laboratory of Parasitology and Ecology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, P.O. Box 812, Yaoundé, Cameroon
| | | | - Betrand Nono Fesuh
- Laboratory of Mathematical Engineering and Information System, Department of Mathematics, National Advances School of Engineering of Yaoundé, University of Yaoundé I, P.O. Box 8390, Yaoundé, Cameroon
| | - Louis-Albert Tchuem Tchuente
- Centre for Schistosomiasis and Parasitology, P.O. Box 7244, Yaoundé, Cameroon.,Laboratory of Parasitology and Ecology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, P.O. Box 812, Yaoundé, Cameroon
| | - Pierre Kamtchouing
- Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, P.O. Box 812, Yaoundé, Cameroon
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Pinto SZ, Friedman R, Van Den Berg EJ. A case of paediatric bladder bilharzioma in Johannesburg, South Africa. Clin Case Rep 2019; 7:1890-1894. [PMID: 31624603 PMCID: PMC6787791 DOI: 10.1002/ccr3.2382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 08/02/2019] [Indexed: 01/22/2023] Open
Abstract
On cystoscopy, a polypoidal tumor was observed and biopsied, and histology confirmed it to be an inflammatory mass with schistosoma eggs called a bilharzioma. We highlight this case to emphasize the silent destructive potential of schistosomiasis which the World Health Organization considers a Neglected Tropical Disease (NTD). A high degree of suspicion is often needed at the primary health care level to prevent morbidity.
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Affiliation(s)
- Sohan Zane Pinto
- Chris Hani Baragwanath HospitalUniversity of WitwatersrandJohannesburgSouth Africa
| | - Robin Friedman
- Chris Hani Baragwanath HospitalUniversity of WitwatersrandJohannesburgSouth Africa
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Ekenze SO, Modekwe VO, Nzegwu MA, Ekpemo SC, Ezomike UO. Testicular Schistosomiasis Mimicking Malignancy in a Child: A Case Report. J Trop Pediatr 2015; 61:304-9. [PMID: 26130620 DOI: 10.1093/tropej/fmv041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Schistosomiasis is an important communicable disease in the developing world. However, testicular schistosomiasis is an extremely rare condition. We report a case of testicular schistosomiasis mimicking testicular tumour in a 13 year old who presented with huge unilateral testicular mass. The dilemma encountered in the diagnosis and treatment of this child is presented to highlight the need for high index of suspicion of this pathology in children with testicular mass presenting from schistosomiasis-endemic areas.
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Affiliation(s)
- Sebastian O Ekenze
- Sub-Department of Paediatric Surgery, University of Nigeria Teaching Hospital, Enugu 400001, Nigeria
| | - Victor O Modekwe
- Sub-Department of Paediatric Surgery, University of Nigeria Teaching Hospital, Enugu 400001, Nigeria
| | - Martin A Nzegwu
- Department of Morbid Anatomy, University of Nigeria Teaching Hospital, Enugu 400001, Nigeria
| | - Samuel C Ekpemo
- Sub-Department of Paediatric Surgery, University of Nigeria Teaching Hospital, Enugu 400001, Nigeria
| | - Uchechukwu O Ezomike
- Sub-Department of Paediatric Surgery, University of Nigeria Teaching Hospital, Enugu 400001, Nigeria
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