Case #208 – July, 2007

A 29-year-old Peace Corp volunteer returned to the United States from Malawi with symptoms that included mild gastrointestinal cramping and intermittent blood in his urine. He sought medical care and the physician ordered a battery of tests including ova and parasite examinations on stool and urine specimens. Figure A shows what was observed on a wet mount of urine sediment. The object was approximately 150 micrometers in length. What is your diagnosis? Based on what criteria?

Figure A

This was a case of urinary schistosomiasis caused by Schistosoma haematobium, a species endemic in Malawi. Diagnostic features were:

the size of the egg and the presence of a terminal spine, which were consistent with S. haematobium.
the presence of miracidium within the egg.