[Diagnosis and treatment of two imported cases with schistosomiasis haematobia in Fujian Province]

OBJECTIVE

To analyze the diagnosis and treatment of two imported cases with schistosomiasis haematobia, so as to provide insights into improving the diagnosis and treatment and avoiding misdiagnosis and mistreatment of imported schistosomiasis haematobia.

METHODS

The medical records and epidemiological data pertaining to the two cases were collected. The stool and urine samples were collected for identification of Schistosoma eggs using the Kato-Katz technique and direct smear method after centrifugal precipitation, and blood samples were collected for detection of anti-Schistosoma antibody. Following definitive diagnosis, the patients were given praziquantel therapy.

RESULTS

The patient 1, a Malagasy, was infected in Madagascar and returned to China for delivery. The case presented intermittent painless terminal hematuria symptoms, and showed no remarkable improvements following multiple-round treatments in several hospitals. In January 2017, she was found to be positive for anti-Schistosoma antibody, negative for feces test, and positive for S. haematobium eggs in urine test, and miracidia were hatched from eggs. Then, the case was diagnosed as schistosomiasis haematobia. Patient 2 worked in Republic of Malawi for many years, and presented intermittent painless terminal hematuria since October 2018; however, no definite diagnosis or effective treatment was received after admission to multiple hospitals. In March 2019, pathological examinations showed a number of eggs in the interstitium of the bladder mass, accompanied by a large number of eosinophils, which was consistent with schistosomiasis cystitis. In April 2019, he was tested positive for serum anti-Schistosoma antibody, negative for the fecal test, and had S. haematobium eggs in urine samples, with miracidia hatched from eggs. Then, the case was diagnosed as schistosomiasis haematobia. Following treatment with praziquantel at a dose of 60 mg/kg, all symptoms disappeared.

CONCLUSIONS

Overseas imported schistosomiasis haematobia is likely to be misdiagnosed. The training pertaining to schistosomiasis control knowledge requires to be improved among clinical professionals, in order to avoid misdiagnosis and mistreatment.

[Imported schistosomiasis haematobia in Suzhou City: a case report]

OBJECTIVE

To report the diagnosis and treatment of an imported case of schistosomiasis haematobia.

METHODS

The patient's medical records were collected, and the clinical features, laboratory diagnosis, epidemiological survey, diagnosis and treatment were analyzed.

RESULTS

The patient had arrived to Sudan and Egypt for many times and had a history of contact with the infested water. After returning to China, the patient reported a gross hematuria with unknown causes. Cystoscopy showed neoplasms in the bladder, and pathologic examinations showed chronic granulomatous inflammation with infiltration of plenty of plasma cells, and parasite eggs. Serological test showed positive for the dipstick dye immunoassay, and the microscopic examination of urine sediment revealed Schistosoma haematobium eggs. Following praziquantel treatment for a month, S. haematobium eggs were still detected in the urine. The case was treated with praziquantel again and cured without adverse reactions.

CONCLUSIONS

Health education should be strengthened among China-aid-African workers to improve the awareness of self-protection. In addition, the diagnosis and treatment should be improved in medical professionals to achieve a timely definitive diagnosis.

[Diagnosis and treatment of imported African schistosomiasis]

This paper summarizes the clinical diagnosis and treatment of imported African schistosomiasis, in order to make the therapeutic standards. Imported African schistosomiasis includes mainly schistosomiasis haematobia and schistosomiasis mansoni in China. In order to set up the operational standards, enhance diagnostic and cure rates, and reduce the complications, we review the related literature combined with our experience over years, and summarize, in this paper, the pathogenic mechanism, and key points of clinical diagnosis and treatment of schistosomiasis haematobia and schistosomiasis mansoni, so as to provide the reference for clinical doctors.