Pulmonary schistosomiasis in a young male: A case report and review of the literature

Secondary Spontaneous Pneumothorax Caused by Pulmonary Schistosomiasis

Schistosomiasis is an endemic disease commonly found in areas of Africa and the Middle East. It is a prevalent parasitic infection in the southern region of Saudi Arabia and Yemen. The most common species found are Schistosoma mansoni and Schistosoma haematobium. Schistosomiasis can manifest in the urinary bladder, liver, and gastrointestinal system. The occurrence of the infection in the lungs is very rare and usually appears after years of initial infection. We report a case of a 23-year-old Yemeni male who presented to the emergency department complaining of sudden, right-sided chest pain with shortness of breath of one day. Examination and chest X-ray revealed the presence of pneumothorax, and a chest tube was inserted accordingly. As the pneumothorax did not resolve and a continuous air leak was present, the patient was taken to the operation theatre on suspicion of a fistula. The diagnostic procedure found the presence of bullae and patterns of inflammatory infection. A resected lung wedge revealed the presence of Schistosoma eggs, and schistosomiasis was diagnosed. In conclusion, spontaneous pneumothorax secondary to infection can present in young healthy males. Meanwhile, schistosomiasis infection must be kept in mind when dealing with patients coming from endemic areas even if they present with no recent visit to endemic areas.

Schistosoma haematobium infection with pulmonary involvement in a traveller returning from Congo: A case report and systematic review of literature on nodular pulmonary schistosomiasis

BACKGROUND

Schistosomiasis is highly prevalent in sub-Saharan Africa and diagnosis is difficult for travel medicine practitioners, because it can affect different organs with atypical manifestations. S. haematobium is mostly associated with urinary involvement and rarely with pulmonary lesions. This review aims to summarise the pulmonary forms associated with schistosomiasis, especially with S. haematobium.

METHOD

Based on a case report of both pulmonary and urogenital schistosomiasis, we performed a systematic literature review of schistosomiasis occurring in migrants and travellers, with a specific focus on pulmonary schistosomiasis.

RESULTS

Pulmonary schistosomiasis can present two different clinical patterns. On the one hand, there is an acute pattern, which more frequently affects non-immune young travellers within three to eight weeks of their return and, on the other hand, there is a chronic pattern, which has been evolving in recent years and which mostly affects people living in endemic areas or migrating from these countries. Nodular pulmonary lesions are described in both patterns. Genus identification should not focus only on known patterns, and identification of S. haematobium should not be associated exclusively with urinary schistosomiasis.

CONCLUSIONS

Pulmonary schistosomiasis, even when resulting from S. haematobium, is a rare but existing infection that appears to be spreading with increasing travel and global migration. Physicians need to be more aware of non-specific symptoms that may reveal an atypical presentation of a tropical disease, in order to avoid the chronic complications which can result from parasitic diseases.

Schistosomiasis and hookworm infection in humans: Disease burden, pathobiology and anthelmintic vaccines

Helminth diseases are the ancient scourges of humans and their damages are 'silent and insidious'. Of the helminth infections, schistosomiasis and hookworm infection have a great impact. This review covers information regarding vaccine candidates against schistosomiasis and hookworms that reached at least up to the phase-1 trial and literatures regarding other vaccine candidates have been excluded. For clinical manifestations, all available literatures were included, and for epidemiology and global burden of the diseases (GBD), literatures only within 2000-2019 were included. Literatures were searched surfing various databases including PubMED, Google Scholar, and Science Direct and overall over 150 literatures were identified. Globally ~250 million people are suffering from schistosomiasis, resulting 1430 thousand DALY (disability adjusted life year) per year. On the other hand, about 1.3 billion people are infected with hookworm (HW), and according to WHO, ~878 million school-age children (SAC) are at risk. HW is estimated to cause 65,000 deaths annually, accounts for 845 thousand DALYs as well as to cause 6-35.3% loss in productivity. Despite tremendous efforts, very few anthelmintic vaccine candidates such as Na-GST-1, Na-APR-1 and Na-ASP-2 against HW, and Sm28GST/Sh28GST, Sm-p80, Sm14 and Sm-TSP-1/SmTSP-2 against schistosomiasis reached up to the clinical trials. More efforts are needed to achieve the WHO targets taken against the maladies.