Urethritis due to Schistosoma haematobium with superimposed gonorrhea

A case of urethritis due to Schistosoma haematobium with superimposed gonorrhea is described. The diagnosis was confirmed by the presence of gram-negative intracellular diplococci in the urethral discharge and of characteristic terminal spined Schistosoma haematobium ova in the urine, as well as by the favorable clinical response to treatment with the antischistosomal drug niridazole. A diagnosis of schistosomiasis should be considered for patients in whom treatment with drugs that are active against the common causes of urethritis fails, particularly when such patients live in an area where bilharzia is endemic or epidemic.