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Shistosomiasis
Case Detail
| Anatomy: Genitourinary |
 Joseph Junewick, MD FACR |
| Diagnostic Category: Infectious-Inflammatory |
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| Created: over 3 years ago |
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| Updated: about 1 year ago |
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| Tags:
PEDS
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| Modality/Study Types:
CT
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Activities:  PDF  ImageJA |
History
Teenager with hematuria.
Case Images
Diagnosis
Shistosomiasis
Findings
CT – 1) Intramural urinary bladder calcifications, most pronounced at the base, 2) Areas of focal thickening of the urinary bladder, and 3) calcification of the distal left ureter.
Discussion
Shistosomiasis ranks only behind malaria in prevalence of parasitic disease in humans. Involvement of the genitourinary system is related exclusively to Shistosoma haematobium which is endemic in Africa, southeastern Mediterranean and the Middle East. Eggs produce miracidia which infect freshwater snails (Bulinus). Within the snail the miracidia form sporocysts. Swimming larvae (cercariae) are released and penetrate skin of humans and travel to the hepatic portal capillaries and eventually mature in the vesicular venous plexus and lay eggs. Eggs are extremely antigenic and produce a granulomatous reaction. Protein, eosinophils and blood are often present in the urine. On sonography the bladder wall may be thickened with mucosal irregularity and polyp formation. Later in the disease, bladder and ureteral fibrosis and calcification may occur and eventually upper tract obstruction .
Reference
Shekel HM, Elsayes KM , AbouElAtta HM. Genitourinary Schistosomiasis: Life Cycle and Radiologic-Pathologic Findings. Radiographic (2012); 32(4):1031-46.