Vesical schistosomiasis, an emerging cause of gross hematuria in developed countries.

Abstract

A 7-year-old boy, originally from Ivory Coast and a resident in Spain for the last 3 weeks, presented to our clinic with hypogastric pain and painful hematuria over the past month. His clinic blood pressure was 90/49 mmHg (p28/ p25). The physical examination was unremarkable. Initial laboratory workup revealed hypereosinophilia (1910 cells/mm3) and elevated levels of total serum IgE (332 IU/ml), with normal kidney function and levels of electrolytes and serum complement C3 and C4. Urinalysis showed leukocyturia, hematuria, and proteinuria (protein/ creatinine ratio 1.53 mg/mg). Abdominal ultrasonography revealed a focal nodular and polypoid thickening of the posterior wall of the bladder (Fig. 1). Urinary microscopy revealed Schistosoma haematobium eggs (Fig. 2). His asymptomatic 10-year-old brother was also examined, revealing the same lesions in the ultrasound scan and presence of eggs in the urine.