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Cavernoma
Heather Borders, MD
over 7 years ago
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Shistosomiasis

Case Detail

Anatomy: Genitourinary
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Infectious-Inflammatory
Created: over 3 years ago
Updated: about 1 year ago
Tags: PEDS
Modality/Study Types: CT
Activities:
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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.



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