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Urinary schistosomiasis: a report of four cases and a review
Insights
Urinary schistosomiasis, a parasitic infection, can cause hematuria and enuresis in children. Prompt diagnosis and treatment with praziquantel offer a complete cure, even in developed countries.
Area of Science:
- Tropical medicine
- Parasitology
- Pediatrics
Background:
- Urinary schistosomiasis is endemic in tropical regions, primarily affecting children and adolescents.
- Hematuria in children in developed countries often suggests bacterial cystitis or structural lesions, leading to different diagnostic pathways.
Observation:
- A family recently returned from Nigeria presented with four children diagnosed with urinary schistosomiasis.
- Symptoms varied from nocturnal enuresis, hematuria, and dysuria in the index case to nocturia in another child; two were asymptomatic.
Findings:
- All four children were successfully treated with a single dose of praziquantel, a novel schistosomicide.
- This case highlights the potential for imported parasitic diseases in non-endemic settings.
Implications:
- Increased awareness of urinary schistosomiasis is crucial for pediatricians in developed nations, especially with global travel.
- Early diagnosis and treatment with praziquantel can prevent long-term complications and ensure a full recovery.
Abstract:
Urinary schistosomiasis is a common cause of hematuria in tropical regions, where it most often affects teenage boys. Children presenting with hematuria in the developed world are usually considered to have bacterial cystitis or a structural lesion and are investigated and treated accordingly. The authors report on a family recently returned to Canada from Nigeria in which all four children had urinary schistosomiasis. Nocturnal enuresis was the presenting symptom in the index case; this patient also had hematuria and dysuria. Nocturia occurred in a second child, and the other two children were asymptomatic. All four were cured by a single dose of praziquantel, a new schistosomicide. The life cycle of the causative organism, the clinical manifestations of schistosomiasis, the host response and treatment with praziquantel are reviewed.