Short communication: Urinary schistosomiasis mimicking a bladder tumour in a Somali student diagnosed in Türkiye.
B Ünal, G İmanlı, F Y İlki et al.
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Case in brief
A 20-year-old Somali student living in Türkiye presented with painless visible haematuria and lower urinary tract symptoms. He had a history of freshwater exposure in Somalia. Although an initial urine sample showed no parasites, microscopy of a repeat terminal-stream sample identified terminal-spined Schistosoma haematobium eggs. Cystoscopy showed a sessile bladder lesion suspicious for malignancy alongside diffuse yellow granular mucosal patches. Resection demonstrated eosinophil-rich chronic active cystitis and subepithelial schistosome eggs, without dysplasia or malignancy. He was treated with praziquantel.
What made this case unusual
The bladder lesion mimicked malignancy, while diffuse yellow granular mucosal patches and schistosome eggs on histology pointed to urinary schistosomiasis.
Diagnostic / clinical pearl
In patients with relevant exposure history, a negative initial urine microscopy does not exclude urinary schistosomiasis; repeat microscopy and attention to terminal-stream urine and characteristic cystoscopic findings can aid diagnosis.