Richter Joachim, Holtfreter Martha, Mouahid Gabriel, Moné Hélène
Tropical Medicine Unit, Department of Gastroenterology, Hepatology and Infectious Diseases, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
Univ. Perpignan Via Domitia, IHPE UMR 5244, CNRS, IFREMER, Univ. Montpellier, 58 avenue Paul Alduy, Bât. R, F-66860, Perpignan, France.
Parasitol Res. 2016 Apr;115(4):1733-5. doi: 10.1007/s00436-016-4944-2. Epub 2016 Feb 6.
A 12-year-old male patient suffered hematuria. Histopathology of a biopsy showed granulomata suspicious for schistosomiasis. The patient had never travelled outside Europe during his entire lifetime. He had taken frequent bathes in various rivers during his last family holidays 5 months earlier in Corsica. Microfiltration of urine revealed viable ova of Schistosoma haematobium with alterated size and shape. Ultrasonography showed a large focal echopoor mass attached to the bladder roof. Four days after antihelminthic therapy, the patient suffered inferior abdominal pain and acute anuria. Ultrasound revealed an approximately 5-cm mass in the bladder lumen suspicious for a large blood clot. After taking non-invasive measures such as drinking high amounts of fluid and treating the lower abdomen with a warm water bag and massage, the clot was excreted with urine and symptoms subsided. The further course was uneventful until 11 months later when hematuria recurred. This time, parasitological urine examination confirmed non-viable schistosome ova. Hematuria was likely due to erosion of the bladder mucosa by calcified non-viable ova.
一名12岁男性患者出现血尿。活检的组织病理学显示有肉芽肿,怀疑为血吸虫病。该患者一生中从未去过欧洲以外的地方。在5个月前于科西嘉岛度过的最后一次家庭假期期间,他经常在不同的河流中沐浴。尿液微滤显示有大小和形状改变的埃及血吸虫活卵。超声检查显示膀胱顶部附着有一个大的局灶性低回声肿块。抗蠕虫治疗4天后,患者出现下腹部疼痛和急性无尿。超声显示膀胱腔内有一个约5厘米的肿块,怀疑是一个大血块。采取大量饮水、用热水袋热敷下腹部和按摩等非侵入性措施后,血块随尿液排出,症状缓解。直到11个月后血尿复发,病情一直平稳。这次,寄生虫学尿液检查证实为无活性的血吸虫卵。血尿可能是由于钙化的无活性虫卵侵蚀膀胱黏膜所致。