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DOI: 10.4103/ijmbs.ijmbs_4_21
Image quiz: A bladder biopsy from a child with hematuria
Clinical Context
[[Figure 1]]. Is an H&E stained section of a bladder biopsy taken from a child who presented with hematuria. The patient spent a few months at a refugee camp by the Nile in Ethiopia before arriving in the USA.
![](https://www.thieme-connect.de/media/10.1055-s-00053247/202101/thumbnails/10-4103-ijmbs-ijmbs-4-21_313511-i313511-1.jpg)
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Question
What is your diagnosis?
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Answer to Image quiz
The diagnosis is Schistosomiasis
[[Figure 1]] featured a section from a fibrotic area of the bladder wall infested with eggs of Schistosoma haematobium highlighted by the arrows in the demarcated image below [[Figure 2]]. This parasitic infection is endemic to the Nile Valley from Ethiopia and Sudan and Egypt. Ancient archival material proves the prevalence of this disease there since the dawn of recorded history. The earliest case of human Schistosomiasis diagnosis (confirmed by immunologic ELISA method) was found in the mummified body of an Egyptian adolescent dating back to more than 5,000 years ago[[1]]. In a study by Miller et al., 15 out of 23 mummies tested showed evidence of schistosomiasis[[2]]. Apparently, hematuria, likely due to schistosomiasis, was so prevalent in ancient Egypt that in a papyrus dated to the Pharaonic era, a palace physician expressed concern if an adolescent boy reaches puberty and reported no blood in his urine; similar to the concern encountered in females reaching adolescent age with no sign of blood or mensuration!
![](https://www.thieme-connect.de/media/10.1055-s-00053247/202101/thumbnails/10-4103-ijmbs-ijmbs-4-21_313511-i313511-2.jpg)
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Schistosomiasis (also known as Bilharzia) is one of the most prevalent parasitic diseases. Schistosoma haematobium is the prevalent species in Africa and the Nile valley. Schistosoma Mansoni is encountered – in addition to Africa- in South America, while Schistosoma Japonicum occurs in Japan, China and South East Asia. The eggs of these parasites are helpful in designating the species at the microscopic level. Schistosoma haematobium eggs are oval and show a terminal spike. Schistosoma Mansoni eggs are also oval but show a lateral spike. The eggs of Schistosoma Japonicum are smaller, round and show a very small lateral spike or no spike.
Author's contribution
None.
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Compliance with ethical principles
Not required.
Reviewers:
Not Applicable (Invited submission)
Editors:
Salem A Beshyah (Abu Dhabi, UAE)
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Conflict of Interest
There are no conflicts of interest.
Financial support and sponsorship
Nil.
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References
- 1 Deelder AM, Miller RL, de Jonge N, Krijger FW. Detection of schistosome antigen in mummies. Lancet 1990;335:724-5.
- 2 Miller RL, Armelagos GJ, Ikram S, De Jonge N, Krijger FW, Deelder AM. Palaeoepidemiology of Schistosoma infection in mummies. BMJ 1992;304:555-6.
Corresponding author
Publikationsverlauf
Eingereicht: 09. Januar 2021
Angenommen: 13. Januar 2021
Artikel online veröffentlicht:
14. Juli 2022
© 2021. The Libyan Authority of Scientific Research and Technologyand the Libyan Biotechnology Research Center. All rights reserved. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License,permitting copying and reproductionso long as the original work is given appropriate credit. Contents may not be used for commercial purposes, oradapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Deelder AM, Miller RL, de Jonge N, Krijger FW. Detection of schistosome antigen in mummies. Lancet 1990;335:724-5.
- 2 Miller RL, Armelagos GJ, Ikram S, De Jonge N, Krijger FW, Deelder AM. Palaeoepidemiology of Schistosoma infection in mummies. BMJ 1992;304:555-6.
![](https://www.thieme-connect.de/media/10.1055-s-00053247/202101/thumbnails/10-4103-ijmbs-ijmbs-4-21_313511-i313511-1.jpg)
![Zoom Image](/products/assets/desktop/css/img/icon-figure-zoom.png)
![](https://www.thieme-connect.de/media/10.1055-s-00053247/202101/thumbnails/10-4103-ijmbs-ijmbs-4-21_313511-i313511-2.jpg)
![Zoom Image](/products/assets/desktop/css/img/icon-figure-zoom.png)