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Nasser Alsharif S, Saleh Alshamrani A, Hadi Asiri D, Yahya Al-Mani S. A Rare Abdominal Pain Associated With Chronic Intestinal Schistosomiasis Diagnosed Endoscopically: A Case Study From Saudi Arabia. Cureus 2024; 16:e58614. [PMID: 38770490 PMCID: PMC11103049 DOI: 10.7759/cureus.58614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2024] [Indexed: 05/22/2024] Open
Abstract
Chronic intestinal schistosomiasis (CIS) refers to the long-term effects of infection with Schistosoma parasites in the intestines. This condition typically develops after repeated or prolonged exposure to contaminated freshwater containing Schistosoma eggs. The current study reports a case of an adult male, who complained of abnormal abdominal and anal pain for a month and had a medical history of complex perianal fistulae. The endoscopic investigation revealed different degrees of hyperemia, concentrated in the sigmoid colon and rectum. Lesions were localized in the rectum and sigmoid colon. Yellow granular hyperplasia, whether concentrated or dispersed, single or multiple polyps, along with observations of mucosal congestion, edema, faint vascular striations, erosions, superficial ulcers, and scattered petechial hemorrhages were noted. Also, the segmented areas of the colon had different degrees of inflammation. The microscopic histopathological analysis showed a culprit of surgical scar tissue. The granulomas harbored Schistosome parasites at the submucosal depth. Also, an erosion in the colonic mucosal tissues accompanied by lymphoplasmacytic and micro-abscess infiltrates was seen. A Schistosoma bilharzial ova was observed in the granuloma at the submucosal level. Endoscopic and histopathological investigations are useful tools to differentiate between CIS and Crohn's disease. These tools can distinguish CIS from Crohn's disease. Early detection and treatment are essential to prevent the progression of the disease and minimize long-term complications.
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Affiliation(s)
- Saeed Nasser Alsharif
- Gastroenterology, Armed Forces Hospital - Southern Region (AFHSR), Khamis Mushait, SAU
| | - Ali Saleh Alshamrani
- Gastroenterology, Armed Forces Hospital - Southern Region (AFHSR), Khamis Mushait, SAU
| | - Dawlah Hadi Asiri
- Internal Medicine, Armed Forces Hospital - Southern Region (AFHSR), Khamis Mushait, SAU
| | - Salihah Yahya Al-Mani
- Internal Medicine, Armed Forces Hospital - Southern Region (AFHSR), Khamis Mushait, SAU
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Dos Santos M, de Faria MT, da Silva JO, Gandra IB, Ribeiro AJ, Silva KA, Nogueira LM, Machado JM, da Silveira Mariano RM, Gonçalves AAM, Ludolf F, Candia-Puma MA, Chávez-Fumagalli MA, Campos-da-Paz M, Giunchetti RC, Galdino AS. A Mini-Review on Elisa-Based Diagnosis of Schistosomiasis. Curr Mol Med 2024; 24:585-598. [PMID: 37143281 DOI: 10.2174/1566524023666230504140828] [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: 10/19/2022] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Schistosomiasis is a neglected tropical parasitic disease caused by trematode worms of the genus schistosoma, which affects approximately 240 million people worldwide. the diagnosis of the disease can be performed by parasitological, molecular, and/or immunological methods, however, the development of new diagnostic methods still essential to guide policy decisions, monitor disease trends and assess the effectiveness of interventions. OBJECTIVE in this sense, the current work summarizes the findings of a systematic review regarding antigens applied in the enzyme-linked immunosorbent assay test, which were patented and published over the last ten years. METHODS the literature search strategy used medical subject heading (mesh) terms to define as descriptors. "schistosoma mansoni" was used in arrangement with the descriptors "immunoassay", "enzyme-linked immunosorbent assay", "elisa", and "antigens", using the "and" connector. the patent search was done using keywords, including diagnosis and schistosoma or schistosomiasis or schistosome. several databases were employed for the patent search, such as intellectual property national institute; european patent office; the united states patent and trademark office; patent scope, and google patents. RESULTS forty-one articles were retrieved, of which only five met the eligibility criteria. seventeen patents were taken from the databases, and a brief description of the most relevant inventions is given here. CONCLUSION schistosomiasis is considered the most important helminthic disease in worldwide. therefore, it is important to of searching for and develops diagnostic methods based on serology to reduce morbidity and mortality caused by the disease.
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Affiliation(s)
- Michelli Dos Santos
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São Joao Del-Rei, Sebastião Gonçalves Coelho, Divinópolis, 400, 35501-296, MG, Brazil
| | - Mariana Teixeira de Faria
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São Joao Del-Rei, Sebastião Gonçalves Coelho, Divinópolis, 400, 35501-296, MG, Brazil
| | - Jonatas Oliveira da Silva
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São Joao Del-Rei, Sebastião Gonçalves Coelho, Divinópolis, 400, 35501-296, MG, Brazil
| | - Isadora Braga Gandra
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São Joao Del-Rei, Sebastião Gonçalves Coelho, Divinópolis, 400, 35501-296, MG, Brazil
| | - Anna Julia Ribeiro
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São Joao Del-Rei, Sebastião Gonçalves Coelho, Divinópolis, 400, 35501-296, MG, Brazil
| | - Kamila Alves Silva
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São Joao Del-Rei, Sebastião Gonçalves Coelho, Divinópolis, 400, 35501-296, MG, Brazil
| | - Lais Moreira Nogueira
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São Joao Del-Rei, Sebastião Gonçalves Coelho, Divinópolis, 400, 35501-296, MG, Brazil
| | - Juliana Martins Machado
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São Joao Del-Rei, Sebastião Gonçalves Coelho, Divinópolis, 400, 35501-296, MG, Brazil
| | - Reysla Maria da Silveira Mariano
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, MG, Brazil
| | - Ana Alice Maia Gonçalves
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, MG, Brazil
| | - Fernanda Ludolf
- Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Mayron Antonio Candia-Puma
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Urb. San José S/N, Umacollo, Arequipa, 04000, Peru
| | - Miguel Angel Chávez-Fumagalli
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Urb. San José S/N, Umacollo, Arequipa, 04000, Peru
| | - Mariana Campos-da-Paz
- Laboratório de Bioativos & NanoBiotecnologia, Universidade Federal de São João Del-Rei, Sebastião Gonçalves Coelho, Divinópolis, 400, 35501-296, MG, Brazil
| | - Rodolfo Cordeiro Giunchetti
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, MG, Brazil
| | - Alexsandro Sobreira Galdino
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São Joao Del-Rei, Sebastião Gonçalves Coelho, Divinópolis, 400, 35501-296, MG, Brazil
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Oliosi E, Angoulvant A, Marteau A, Paris L, Bouchaud O, Guegan H, Choinier P, Tattevin P, Gangneux JP, Delobre G, Houzé S, Jauréguiberry S. Chronic schistosomiasis imported in France: A retrospective multicentre analysis of 532 patients, calling for international recommendations. Travel Med Infect Dis 2023; 56:102644. [PMID: 37820948 DOI: 10.1016/j.tmaid.2023.102644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 09/02/2023] [Accepted: 09/25/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Schistosomiasis is a major public health issue for migrants. This study aims to describe the clinical presentation and management of imported schistosomiasis in France. METHODS We included all new cases of schistosomiasis in patients aged ≥18 years, defined by a positive specific Western blot and/or a positive parasitological analysis of urine, stool or biopsy, between January 1, 2016, and December 31, 2019, in 4 laboratories in Paris and Western France. RESULTS Over the study period, 532 patients were included. Mean age was 37 years (18-91), and 461/532 (87 %) were men. Among 476/532 (89 %) patients born in an endemic area, 433 (91 %) were born in sub-Saharan Africa. Most of the patients (405/532, 76 %) had only a positive serology, and 127/532 (24 %) had ova on microscopic examination. Among 361/532 (68 %) who had at least one urine, stool or biopsy analysis, microscopic analysis was positive in 127 (35 %). Imaging showed lesions compatible with schistosomiasis in 88/164 (54 %) patients with clinical symptoms and 13/29 (45 %) patients without (p = 0.5). Patients who arrived in France less than one year before diagnosis were more likely to have clinical symptoms than those who arrived in France 1-5 years and >5 years prior to diagnosis (52 %, 41 % and 43 %, respectively, p = 0.03). Two-hundred and seventeen patients (40.8 %) were left untreated. CONCLUSION Approximately 50 % of patients with imported chronic schistosomiasis have radiological abnormalities, whether they are symptomatic or not, and management is heterogeneous. Multidisciplinary international guidelines are requested to clarify the management of this neglected disease.
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Affiliation(s)
- Emma Oliosi
- Université Paris-Saclay, Service des Maladies Infectieuses et Tropicales, AP-HP, Hôpital Bicêtre, Le Kremlin Bicêtre, 94270, France.
| | - Adela Angoulvant
- Université Paris-Saclay, Laboratoire de Parasitologie-mycologie, AP-HP, Hôpital Bicêtre, Le Kremlin Bicêtre, 94270, France
| | - Anthony Marteau
- Université Sorbonne Paris Nord, Service de Parasitologie-Mycologie, AP-HP, Hôpital Avicenne, Bobigny, 93000, France
| | - Luc Paris
- Sorbonne Université, Service de Parasitologie-Mycologie, AP-HP, Hôpital Pitié-Salpêtrière, Paris, 75013, France
| | - Olivier Bouchaud
- Université Sorbonne Paris Nord, Service des Maladies Infectieuses et Tropicales, AP-HP, Hôpital Avicenne, Bobigny, 93000, France
| | - Hélène Guegan
- Université Rennes, CHU de Rennes, Inserm, Irset (Institut de Recherche en Santé, Environnement et Travail) UMR_S 1085, Rennes, 35000, France
| | - Pascaline Choinier
- Sorbonne Université, Service de Pneumologie, AP-HP, Hôpital Tenon, Paris, 75020, France
| | - Pierre Tattevin
- Université Rennes 1, Service des Maladies Infectieuses et Tropicales, Hôpital Pontchaillou, Rennes, 35000, France
| | - Jean-Pierre Gangneux
- Université Rennes, CHU de Rennes, Inserm, Irset (Institut de Recherche en Santé, Environnement et Travail) UMR_S 1085, Rennes, 35000, France
| | | | - Sandrine Houzé
- Université Paris-Cité, Laboratoire de Parasitologie-Mycologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, 75018, France
| | - Stéphane Jauréguiberry
- Université Paris-Saclay, Service des Maladies Infectieuses et Tropicales, AP-HP, Hôpital Bicêtre, Le Kremlin Bicêtre, 94270, France; Société Française de Médecine des Voyages, France.
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Comelli A, Genovese C, Gobbi F, Brindicci G, Capone S, Corpolongo A, Crosato V, Mangano VD, Marrone R, Merelli M, Prato M, Santoro CR, Scarso S, Vanino E, Marchese V, Antinori S, Mastroianni C, Raglio A, Bruschi F, Minervini A, Donà D, Garazzino S, Galli L, Lo Vecchio A, Galli A, Dragoni G, Cricelli C, Colacurci N, Ferrazzi E, Pieralli A, Montresor A, Richter J, Calleri G, Bartoloni A, Zammarchi L. Schistosomiasis in non-endemic areas: Italian consensus recommendations for screening, diagnosis and management by the Italian Society of Tropical Medicine and Global Health (SIMET), endorsed by the Committee for the Study of Parasitology of the Italian Association of Clinical Microbiologists (CoSP-AMCLI), the Italian Society of Parasitology (SoIPa), the Italian Society of Gastroenterology and Digestive Endoscopy (SIGE), the Italian Society of Gynaecology and Obstetrics (SIGO), the Italian Society of Colposcopy and Cervico-Vaginal Pathology (SICPCV), the Italian Society of General Medicine and Primary Care (SIMG), the Italian Society of Infectious and Tropical Diseases (SIMIT), the Italian Society of Pediatrics (SIP), the Italian Society of Paediatric Infectious Diseases (SITIP), the Italian Society of Urology (SIU). Infection 2023; 51:1249-1271. [PMID: 37420083 PMCID: PMC10545632 DOI: 10.1007/s15010-023-02050-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 05/08/2023] [Indexed: 07/09/2023]
Affiliation(s)
- Agnese Comelli
- Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Camilla Genovese
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
- II Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Federico Gobbi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Italy
- University of Brescia, Brescia, Italy
| | - Gaetano Brindicci
- AOU Consorziale Policlinico di Bari, Infectious Diseases Unit, Bari, Italy
| | - Susanna Capone
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili of Brescia, Brescia, Italy
| | - Angela Corpolongo
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' (IRCCS), Rome, Italy
| | - Verena Crosato
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili of Brescia, Brescia, Italy
| | - Valentina Dianora Mangano
- Department of Translational Research, N.T.M.S, Università di Pisa, Pisa, Italy
- Programma Di Monitoraggio Delle Parassitosi e f.a.d, AOU Pisana, Pisa, Italy
| | - Rosalia Marrone
- National Institute for Health, Migration and Poverty, Rome, Italy
| | - Maria Merelli
- Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy
| | - Marco Prato
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | | | - Salvatore Scarso
- National Center for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Elisa Vanino
- Unit of Infectious Diseases, Ospedale "Santa Maria delle Croci", AUSL Romagna, Ravenna, Italy
| | - Valentina Marchese
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
| | - Spinello Antinori
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Claudio Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Annibale Raglio
- Committee for the Study of Parasitology of the Italian Association of Clinical Microbiologists (CoSP-AMCLI), Milan, Italy
| | - Fabrizio Bruschi
- Department of Translational Research, N.T.M.S, Università di Pisa, Pisa, Italy
- Programma Di Monitoraggio Delle Parassitosi e f.a.d, AOU Pisana, Pisa, Italy
| | - Andrea Minervini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Department of Urology, University of Florence, Florence, Italy
| | - Daniele Donà
- Division of Paediatric Infectious Diseases, Department for Women's and Children's Health, University of Padua, Padua, Italy
| | - Silvia Garazzino
- Paediatric Infectious Disease Unit, Regina Margherita Children's Hospital, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Luisa Galli
- Infectious Diseases Unit, Meyer Children's Hospital, IRCCS, Florence, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Andrea Lo Vecchio
- Department of Translational Medical Sciences, Paediatric Infectious Disease Unit, University of Naples Federico II, Naples, Italy
| | - Andrea Galli
- Gastroenterology Research Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Gabriele Dragoni
- Gastroenterology Research Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Claudio Cricelli
- Health Search-Istituto di Ricerca della SIMG (Italian Society of General Medicine and Primary Care), Florence, Italy
| | - Nicola Colacurci
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Enrico Ferrazzi
- Department of Woman, New-Born and Child, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Annalisa Pieralli
- Ginecologia Chirurgica Oncologica, Careggi University and Hospital, Florence, Italy
| | - Antonio Montresor
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Joachim Richter
- Institute of International Health, Charité Universitätsmedizin, Corporate Member of Freie und Humboldt Universität Berlin and Berlin Institute of Health, Berlin, Germany
| | - Guido Calleri
- Amedeo Di Savoia Hospital, ASL Città di Torino, Turin, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy.
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Sinkala E, Ahmed HY, Sibomana JP, Lee MH, Kassa B, Kumar R, Mazimba S, Binegdie AB, Mpisa S, Wamundila K, Graham BB, Hilton JF. Rationale and design of a screening study to detect schistosomiasis-associated pulmonary hypertension in Ethiopia and Zambia. Pulm Circ 2022; 12:e12072. [PMID: 35514775 PMCID: PMC9063961 DOI: 10.1002/pul2.12072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/28/2022] [Accepted: 03/27/2022] [Indexed: 11/05/2022] Open
Abstract
Schistosomiasis is a major cause of pulmonary arterial hypertension (PAH) worldwide, but the prevalence and risk factors for schistosomiasis-associated PAH (SchPAH) development are not well understood. Schistosomiasis-associated hepatosplenic disease (SchHSD) is thought to be a major risk factor for PAH development. Herein, we describe our plans for prospectively screening SchHSD subjects for clinical evidence of PAH at two major academic medical centers and national referral hospitals in Addis Ababa, Ethiopia and Lusaka, Zambia. The screening study will primarily be conducted by echocardiography, in addition to clinical assessments. Plasma samples will be drawn and banked for subsequent analysis based on preclinical animal model rationale. If successful, this study will demonstrate feasibility of conducting prospective cohort studies of SchPAH screening in schistosomiasis-endemic regions of Africa, and provide initial data on clinic-based disease prevalence and potential mechanistic biomarkers underlying disease pathogenesis.
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Affiliation(s)
- Edford Sinkala
- Hepatology Clinic, Department of MedicineUniversity of Zambia Teaching HospitalLusakaZambia
| | - Hanan Yusuf Ahmed
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Tikur Anbessa Specialized Hospital, College of Health SciencesUniversity of Addis AbabaAddis AbabaEthiopia
| | - Jean Pierre Sibomana
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Tikur Anbessa Specialized Hospital, College of Health SciencesUniversity of Addis AbabaAddis AbabaEthiopia
- Department of Medicine, Butare University Teaching HospitalUniversity of RwandaButareRwanda
| | - Michael H. Lee
- Department of MedicineUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Biruk Kassa
- Department of MedicineUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Rahul Kumar
- Department of MedicineUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Sula Mazimba
- Department of Medicine, Division of CardiologyUniversity of Virginia School of MedicineCharlottesvilleVirginiaUSA
| | - Amsalu B. Binegdie
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Tikur Anbessa Specialized Hospital, College of Health SciencesUniversity of Addis AbabaAddis AbabaEthiopia
| | - Sydney Mpisa
- Hepatology Clinic, Department of MedicineUniversity of Zambia Teaching HospitalLusakaZambia
| | - Kawana Wamundila
- Hepatology Clinic, Department of MedicineUniversity of Zambia Teaching HospitalLusakaZambia
| | - Brian B. Graham
- Department of MedicineUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Joan F. Hilton
- Department of Epidemiology and BiostatisticsUniversity of California San FranciscoSan FranciscoCaliforniaUSA
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Schistosomiasis at the Crossroad to Elimination: Review of Eclipsed Research with Emphasis on the Post-Transmission Agenda. Trop Med Infect Dis 2022; 7:tropicalmed7040055. [PMID: 35448830 PMCID: PMC9029828 DOI: 10.3390/tropicalmed7040055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/18/2022] [Accepted: 03/24/2022] [Indexed: 02/06/2023] Open
Abstract
While chronic schistosomiasis is pathologically well defined, the acute form of the disease is less well understood. It is generally agreed that early lesions, such as lung nodules and bladder polyps, are reversible, which impedes identification of the time elapsed since exposure. The intermediate stage between the acute and the chronic forms of schistosomiasis requires further investigation, as does the clinical stage due to lesions remaining after treatment. With current schistosomiasis control efforts gradually progressing to elimination, there is a need to focus on post-transmission schistosomiasis, which not only refers to remaining lesions from previous infections, but also accounts for the potential presence of surviving worms after treatment. This issue is particularly salient for migrants from endemic to non-endemic countries and should be kept in mind for returning expatriates from schistosomiasis-endemic countries. Negative stool examination or urine filtration are generally taken as indicative of cure since rectoscopy for Schistosoma mansoni infection, or cystoscopy for S. haematobium infection, are rarely performed. However, pathology of affected organs may persist indefinitely, while potentially remaining live worms could produce additional pathology. Hence, post-transmission schistosomiasis can prevail for years after elimination of the disease, and thus, warrant further attention.
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7
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Cimini A, Ricci M, Gigliotti PE, Pugliese L, Chiaravalloti A, Danieli R, Schillaci O. Medical Imaging in the Diagnosis of Schistosomiasis: A Review. Pathogens 2021; 10:pathogens10081058. [PMID: 34451522 PMCID: PMC8401107 DOI: 10.3390/pathogens10081058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/14/2021] [Accepted: 08/18/2021] [Indexed: 12/15/2022] Open
Abstract
Schistosomiasis is one of the most important parasitic diseases and it is endemic in tropical and subtropical areas. Clinical and laboratory data are fundamental for the diagnosis of schistosomiasis, but diagnostic imaging techniques such as x-rays, ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT) may be helpful in the evaluation of disease severity and complications. In this context, the aim of this review is to explore the actual role of diagnostic imaging in the diagnosis of schistosomiasis, underlining advantages and drawbacks providing information about the utilization of diagnostic imaging techniques in this context. Furthermore, we aim to provide a useful guide regarding imaging features of schistosomiasis for radiology and nuclear medicine physicians of non-endemic countries: in fact, in the last years non-endemic countries have experienced important flows of migrants from endemic areas, therefore it is not uncommon to face cases of this disease in daily practice.
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Affiliation(s)
- Andrea Cimini
- Department of Biomedicine and Prevention, University Tor Vergata, Via Cracovia 50, 00133 Rome, Italy; (M.R.); (P.E.G.); (L.P.); (A.C.); (O.S.)
- Correspondence: ; Tel.: +39-(06)-20902467
| | - Maria Ricci
- Department of Biomedicine and Prevention, University Tor Vergata, Via Cracovia 50, 00133 Rome, Italy; (M.R.); (P.E.G.); (L.P.); (A.C.); (O.S.)
| | - Paola Elda Gigliotti
- Department of Biomedicine and Prevention, University Tor Vergata, Via Cracovia 50, 00133 Rome, Italy; (M.R.); (P.E.G.); (L.P.); (A.C.); (O.S.)
| | - Luca Pugliese
- Department of Biomedicine and Prevention, University Tor Vergata, Via Cracovia 50, 00133 Rome, Italy; (M.R.); (P.E.G.); (L.P.); (A.C.); (O.S.)
- Department of Radiology, San Giovanni Calibita Fatebenefratelli Hospital, Via di Ponte di Quattro Capi 39, 00186 Rome, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University Tor Vergata, Via Cracovia 50, 00133 Rome, Italy; (M.R.); (P.E.G.); (L.P.); (A.C.); (O.S.)
- Nuclear Medicine Section, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Via Atinense 18, 86077 Pozzilli, Italy
| | - Roberta Danieli
- Department of Human Sciences and Promotion of the Quality of Life, University San Raffaele, Via di Val Cannuta 247, 00166 Rome, Italy;
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, Via Cracovia 50, 00133 Rome, Italy; (M.R.); (P.E.G.); (L.P.); (A.C.); (O.S.)
- Nuclear Medicine Section, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Via Atinense 18, 86077 Pozzilli, Italy
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Parasitological and Biochemical Efficacy of the Active Ingredients of Allium sativum and Curcuma longa in Schistosoma mansoni Infected Mice. Molecules 2021; 26:molecules26154542. [PMID: 34361695 PMCID: PMC8347393 DOI: 10.3390/molecules26154542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/11/2021] [Accepted: 07/24/2021] [Indexed: 01/15/2023] Open
Abstract
The active ingredients allicin and curcumin have a wide range of actions against fungi, bacteria, and helminths. Therefore, the study was aimed to evaluate the efficacy of allicin (AL) and curcumin (CU) as antischistosomal drugs and their biochemical effects in normal and Schistosoma mansoni-infected mice. Praziquantel (PZQ) was administrated for two successive days while AL or CU was given for two weeks from the week 7th postinfection (PI). The possible effect of different regimens on Schistosoma worms was evaluated by measuring the percentage of the recovered worms, tissue egg load, and oogram pattern. Serum alanine transaminase activity and levels of triglycerides, cholesterol, and uric acid were measured. Liver tissue malondialdehyde and reduced glutathione levels besides, the activities of glutathione-S-transferase, superoxide dismutase and catalase were assessed for the oxidative/antioxidant condition. DNA electrophoresis of liver tissue was used to indicate the degree of fragmentation. There was a significant reduction in the recovered worms and egg load, with a marked change of oogram pattern in all treated groups with PZQ, AL, and CU in comparison with infected-untreated mice. PZQ, AL, and CU prevented most of the hematological and biochemical disorders, as well as significantly improved the antioxidant capacity and enhanced DNA fragmentation in the liver tissue of schistosomiasis mice compared to the infected-untreated group. These promising results suggest that AL and CU are efficient as antischistosomal drugs, and it would be beneficial to test their combination to understand the mechanism of action and the proper period of treatment leading to the best result.
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Leblanc C, Brun S, Bouchaud O, Izri A, Ok V, Caseris M, Sorge F, Pham LL, Paugam A, Paris L, Jaureguiberry S, Bloch-Queyrat C, Boubaya M, Faye A, Mariani P, de Pontual L. Imported schistosomiasis in Paris region of France: A multicenter study of prevalence and diagnostic methods. Travel Med Infect Dis 2021; 41:102041. [PMID: 33785455 DOI: 10.1016/j.tmaid.2021.102041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 03/18/2021] [Accepted: 03/22/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND There are few data on imported schistosomiasis - especially in children. The objectives of the present study were to estimate the prevalence of imported schistosomiasis in at-risk children in the greater Paris region of France and to compare diagnostic methods. METHOD Children at risk of schistosomiasis who consulted or were hospitalized in four hospitals in the greater Paris region were prospectively included. Clinical and laboratory data were collected. Urine and feces samples were screened for Schistosoma spp. using microscopy, a point-of-care circulating cathodic antigen and a real-time polymerase chain reaction assay. Serum samples were screened using Western blot, ELISA, indirect hemagglutination, and immunochromatographic assays. The diagnosis was characterized as confirmed (positive microscopy analysis) and as suspected (positive ELISA and Western blot assays). The prevalence of schistosomiasis and the tests' performances were estimated using the latent class method. RESULTS A total of 114 children were included. Most of the children were newly arrived migrants from sub-Saharan Africa. The mean age was 13.2 years-old. There were 12 (10.5%) confirmed cases and 13 (11.4%) suspected cases. Half of the confirmed and suspected cases were asymptomatic. The prevalence was 24.3%. The ELISA and the Western blot assays presented the same sensitivity (83%) and specificity (99%). The serum immunochromatographic assay also showed good performance. CONCLUSIONS The high prevalence of imported schistosomiasis among at-risk children in the greater Paris region confirms the need for systematic screening. A serum immunochromatographic assay appears to be one of the most effective screening methods for a low cost.
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Affiliation(s)
- Claire Leblanc
- Department of Pediatrics, AP-HP University Paris 13, Jean Verdier Hospital, Bondy, France.
| | - Sophie Brun
- Department of Parasitology-Mycology, AP-HP University Paris 13, Avicenne Hospital, Bobigny, France
| | - Olivier Bouchaud
- Department of Infectious and Tropical Diseases, AP-HP University Paris 13, Avicenne Hospital, Bobigny, France
| | - Arezki Izri
- Department of Parasitology-Mycology, AP-HP University Paris 13, Avicenne Hospital, Bobigny, France
| | - Vichita Ok
- Department of Parasitology-Mycology, AP-HP University Paris 13, Avicenne Hospital, Bobigny, France
| | - Marion Caseris
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP University Paris Diderot, Robert Debré Hospital, Paris, France
| | - Fréderic Sorge
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP University Paris Descartes, Necker-Enfants Malades Hospital, Paris, France
| | - Luu-Ly Pham
- Department of Pediatrics, AP-HP University Paris 13, Jean Verdier Hospital, Bondy, France
| | - André Paugam
- Department of Parasitology-Mycology, AP-HP University Paris Descartes, Cochin Hospital, Paris, France
| | - Luc Paris
- Department of Parasitology-Mycology, AP-HP Sorbonne Université, Pitié-Salpétrière Hospital, Paris, France
| | - Stéphane Jaureguiberry
- Department of Infectious and Tropical Diseases, AP-HP University Paris -Sud Saclay, Kremlin Bicêtre Hospital, Le Kremlin Bicêtre, France
| | - Coralie Bloch-Queyrat
- Department of Clinical Research, AP-HP University Paris 13, Avicenne Hospital, Bobigny, France
| | - Marouane Boubaya
- Department of Clinical Research, AP-HP University Paris 13, Avicenne Hospital, Bobigny, France
| | - Albert Faye
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP University Paris Diderot, Robert Debré Hospital, Paris, France
| | - Patricia Mariani
- Department of Microbiology, AP-HP University Paris Diderot, Robert Debré Hospital, Paris, France
| | - Loïc de Pontual
- Department of Pediatrics, AP-HP University Paris 13, Jean Verdier Hospital, Bondy, France
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Folliero V, Zannella C, Chianese A, Stelitano D, Ambrosino A, De Filippis A, Galdiero M, Franci G, Galdiero M. Application of Dendrimers for Treating Parasitic Diseases. Pharmaceutics 2021; 13:343. [PMID: 33808016 PMCID: PMC7998910 DOI: 10.3390/pharmaceutics13030343] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/23/2021] [Accepted: 03/01/2021] [Indexed: 01/02/2023] Open
Abstract
Despite advances in medical knowledge, parasitic diseases remain a significant global health burden and their pharmacological treatment is often hampered by drug toxicity. Therefore, drug delivery systems may provide useful advantages when used in combination with conventional therapeutic compounds. Dendrimers are three-dimensional polymeric structures, characterized by a central core, branches and terminal functional groups. These nanostructures are known for their defined structure, great water solubility, biocompatibility and high encapsulation ability against a wide range of molecules. Furthermore, the high ratio between terminal groups and molecular volume render them a hopeful vector for drug delivery. These nanostructures offer several advantages compared to conventional drugs for the treatment of parasitic infection. Dendrimers deliver drugs to target sites with reduced dosage, solving side effects that occur with accepted marketed drugs. In recent years, extensive progress has been made towards the use of dendrimers for therapeutic, prophylactic and diagnostic purposes for the management of parasitic infections. The present review highlights the potential of several dendrimers in the management of parasitic diseases.
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Affiliation(s)
- Veronica Folliero
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (C.Z.); (A.C.); (D.S.); (A.A.); (M.G.)
| | - Carla Zannella
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (C.Z.); (A.C.); (D.S.); (A.A.); (M.G.)
| | - Annalisa Chianese
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (C.Z.); (A.C.); (D.S.); (A.A.); (M.G.)
| | - Debora Stelitano
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (C.Z.); (A.C.); (D.S.); (A.A.); (M.G.)
| | - Annalisa Ambrosino
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (C.Z.); (A.C.); (D.S.); (A.A.); (M.G.)
| | - Anna De Filippis
- Department of Pharmacy, University of Naples “Federico II”, 80131 Naples, Italy;
| | - Marilena Galdiero
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (C.Z.); (A.C.); (D.S.); (A.A.); (M.G.)
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy;
| | - Massimiliano Galdiero
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.F.); (C.Z.); (A.C.); (D.S.); (A.A.); (M.G.)
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Rashed HAEH, Abu Almaaty AH, Soliman MFM, El-Shenawy NS. The in Vitro Antischistosomal Activity and Genotoxicity of the Active Ingredients of Allium sativum (allicin) and Curcuma longa (curcumin). IRANIAN JOURNAL OF PARASITOLOGY 2021; 16:101-110. [PMID: 33786052 PMCID: PMC7988669 DOI: 10.18502/ijpa.v16i1.5540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background: In this study, we assessed the in vitro antischistosomal activity of the active ingredients of Allium sativum (allicin) and Curcuma longa (curcumin) on Schistosoma mansoni. Methods: This study was conducted in Faculty of Science, Port said University, Egypt (2018). Adult worms were exposed to a range of concentrations of AL or CU, and worm survival was assessed 24 h post-exposure to calculate the lethal concentration of the compounds. Scanning electron microscopy was used to assess ultrastructural changes in the surface of AL- or CU- treated worms. The genotoxicities of AL and CU on S. mansoni were determined by DNA fragmentation analysis. Results: We determined the concentrations of AL and CU required to kill 50% of S. mansoni (LC50
). The LC50 of AL was 8.66 μL/mL, whereas 100% mortality of S. mansoni was achieved by AL at concentrations of 50 μL/mL. The LC50 of CU was 87.25 μL/mL, with the highest mortality of 91.3% seen after 24 h exposure to 100 μg/mL CU. Ultrastructural studies revealed that exposure to either AL or CU led to mild or severe surface damage to S. mansion, respectively. The degree of damage in the worms was sex-dependent. Interestingly, while CU exposure resulted in DNA fragmentation in S. mansoni worms, we observed no genotoxic effects of AL. Conclusion: Both AL and CU exhibit antischistosomal activity; the study provided evidence suggesting that these compounds act through distinct mechanisms. These promising results encourage further investigation into these compounds as potential antischistosomal agents, either alone or as complementary treatments to praziquantel.
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Roure S, Valerio L, Pérez-Quílez O, Fernández-Rivas G, Martínez-Cuevas O, Alcántara-Román A, Viasus D, Pedro-Botet ML, Sabrià M, Clotet B. Epidemiological, clinical, diagnostic and economic features of an immigrant population of chronic schistosomiasis sufferers with long-term residence in a non-endemic country (North Metropolitan area of Barcelona, 2002-2016). PLoS One 2017; 12:e0185245. [PMID: 28953954 PMCID: PMC5617205 DOI: 10.1371/journal.pone.0185245] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 09/09/2017] [Indexed: 12/28/2022] Open
Abstract
Background Schistosomiasis, one of the neglected tropical diseases (NTD) listed by the WHO, is an acute and chronic parasitic disease caused by blood flukes (trematode worms) of the genus Schistosoma. Complications of long-term infestation include liver cirrhosis, bladder tumors and kidney failure. The objective of this study was to carry out a clinical and epidemiological characterization of a schistosomiasis-diagnosed immigrant population with long-term residencein the EU as well as to evaluate the diagnostic methods available to date. Methods and results A total of 61 individuals with Schistosoma infection who received medical attention between June 2002 and June 2016 at the North Metropolitan International Health Unit in Barcelona (Catalonia, Spain), were included in the study. All patients were sub-Saharan African immigrants. The majority were male (91.8%) with a median age of 34 years. Symptoms attributable to infection such as haematuria, abdominal pain and dysuria were recorded in up to 90% of patients. The percentage of eosinophils decreased amongst older patients (p = 0.002) and those with symptoms associated with urinary tract infections (p = 0.017). Serology was used for diagnosis in 80.3% of the cases, with microscopic examination showing the remaining 9.8% positive for parasite eggs. Direct microbiological diagnosis was more useful in patients with less than 5 years of residence in the EU (p = 0.05). Chronic complications were present in 22 (36%) of the patients, with renal failure affecting 20 (33%). Of these 20, 6(10%) developed terminal renal failure and required hemodialysis, while 3 (5%) received a renal transplantation. Conclusion Morbidity associated with chronic long-term schistosomiasis is frequent among African immigrants in non-endemic countries. Better diagnostic tools and appropriate early treatment would prevent the development of visceral damage. Thorough screening in selected patients would also be useful to avoid chronic complications.
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Affiliation(s)
- Sílvia Roure
- North Metropolitan International Health Unit PROSICS, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
- * E-mail:
| | - Lluís Valerio
- North Metropolitan International Health Unit PROSICS, Servei Atenció Primària, Santa Coloma de Gramenet, Barcelona, Spain
| | - Olga Pérez-Quílez
- North Metropolitan International Health Unit PROSICS, Servei Atenció Primària, Santa Coloma de Gramenet, Barcelona, Spain
| | - Gema Fernández-Rivas
- Department of Microbiology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
| | - Octavio Martínez-Cuevas
- North Metropolitan International Health Unit PROSICS, Servei Atenció Primària, Santa Coloma de Gramenet, Barcelona, Spain
| | - Albert Alcántara-Román
- North Metropolitan International Health Unit PROSICS, Servei Atenció Primària, Santa Coloma de Gramenet, Barcelona, Spain
| | - Diego Viasus
- Health Sciences Division, Faculty of Medicine, Hospital Universidad del Norte and Universidad del Norte, Barranquilla, Colombia
| | - M. Luisa Pedro-Botet
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
| | - Miquel Sabrià
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
| | - Bonaventura Clotet
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
- AIDS Research Institute-IrsiCaixa, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
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Hassan EA, Abdel-Rahman MA, Ibrahim MM, Soliman MFM. In vitro antischistosomal activity of venom from the Egyptian snake Cerastes cerastes. Rev Soc Bras Med Trop 2017; 49:752-757. [PMID: 28001223 DOI: 10.1590/0037-8682-0241-2016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 10/18/2016] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION: We studied the potential in vitro antischistosomal activity of Cerastes cerastes venom on adult Schistosoma mansoni worms. METHODS: Live specimens of the horned viper snake, C. cerastes were collected from the Aswan Governorate (Egypt). Venom was collected from snakes by manual milking. Worms of S. mansoni were obtained from infected hamsters by perfusion and isolated from blood using phosphate buffer. Mortality rates of worms were monitored after 3 days of exposure to snake venom at LC50 and various sublethal concentrations (10, 5, 2.5µg/ml). Scanning electron microscopy was used to investigate tegumental changes in treated worms after exposure to LC50 doses of venom. RESULTS: The LC50 of C. cerastes venom was 21.5µg/ml. The effect of C. cerastes venom on Schistosoma worms varied according to their sex. The mortality rate of male and female worms after 48-h exposure was 83.3% and 50%, respectively. LC50 of C. cerastes venom induced mild to severe tegumental damage in Schistosoma worms in the form of destruction of the oral sucker, shrinkage and erosion of the tegument, and loss of some tubercle spines. CONCLUSIONS: The present study demonstrated that C. cerastes venom exerts potential in vitro antischistosomal activity in a time and dose-dependent manner. These results may warrant further investigations to develop novel schistosomicidal agents from C. cerastes snake venom.
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Affiliation(s)
- Ehssan Ahmed Hassan
- Zoology Department, Faculty of Science, Suez Canal University, Ismailia, Egypt
| | | | - Mohamed Moussa Ibrahim
- Zoology Department, Faculty of Science, Suez Canal University, Ismailia, Egypt.,Biology Department, Faculty of Science, Al-Baha University, Al-Baha, Saudi Arabia
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Zepeda CM, Coffey KH. Schistosoma haematobium Infection That Mimics Bladder Cancer in a 66-Year-Old Ethnic Egyptian Man. Lab Med 2015; 46:338-42. [PMID: 26489680 DOI: 10.1309/lm96ejppbyadiovc] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
PATIENT 66-year-old ethnic Egyptian man. CHIEF COMPLAINT Hematuria. HISTORY OF PRESENT ILLNESS The patient had a history of multiple episodes of gross hematuria for the past 5 years. Because the hematuria usually resolved on its own, he did not seek medical attention during that time. Bladder cancer was suspected. PAST MEDICAL HISTORY The patient had a history of coronary artery disease, hypertension, nephrolithiasis, congestive heart failure, lifelong smoking, and ischemic cardiomyopathy. He has been taking the anticoagulants clopidogrel (Plavix) and warfarin (Coumadin). RESIDENCY HISTORY The patient is originally from Egypt and has been living in the United States for the past 10 years. PRINCIPAL LABORATORY FINDINGS A complete blood count showed a hemoglobin of 13.0 g per dL (reference range, 14.0 to 18.0 g per dL), hematocrit 40% (40% to 54%), red blood cell count (RBC) 4.65 × 10(9) per L (4.60 to 6.00), and platelet count 179 × 10(9) per L (150 to 450). The urinalysis results showed 3+ protein, 4+ blood, and urine RBC of greater than 100 per high power field (hpf). The urinalysis results did not indicate the presence of parasitic ova or adult parasites. Based on these results, the physician ordered cystoscopic testing, suspecting bladder cancer. Analysis of the bladder tissue showed inflammation (Image 1) and several ova that were consistent with developing Schistosoma (Image 2). Many of the ova were calcified and surrounded by severely inflamed tissue (Image 3).
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Affiliation(s)
| | - Kristen H Coffey
- Department of Clinical Laboratory Sciences, University of West Florida, Pensacola, Florida
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