Schistosomiasis: an unusual finding of the cervix

Schistosomiasis remains a major threat to women's health in many resource-poor countries and is being seen with increasing frequency in developed countries among immigrants and tourists who have a history of freshwater exposure in endemic areas.

A 28-year-old asymptomatic African immigrant presented with an abnormal Pap test result showing rare atypical squamous cells. Colposcopy examination showed pale-yellow, finely granular cervical lesions. Calcified Schistosoma hematobium eggs were identified by histology but were absent in urine and stool specimens. Praziquantel treatment was initiated promptly, avoiding significant morbidity.

The differential diagnosis of female genital schistosomiasis should be considered for patients who have a history of residence in or travel to endemic areas, including asymptomatic patients and patients presenting a long time after exposure.