I have found a urine sample with Schistosoma mansoni ova (lateral spikes!) and wondered how comes even with the repeated sample collection and on an account that the patient has no any clinical features suggestive of ano-rectal fistula?
Dear Kelvin
I am unaware of any published study, even case report of urinary schistosomiasis due to S. mansoni. You finding is very interesting and should be reported in a good journal as a Case Report!
Is not commom,but not impossible.S.mansoni eggs in sperma is not very rare.Eggs has been found in all tissues and organs:lungs,ovary,kidney,brain,skin,etc,etc
The finding is really interesting. In my experience in parasitology I've never encountered such finding. Your finding would shed more light if you collect repeated samples on different days and if you also check fecal sample for S. mansoni egg. Also your finding would brought more knowledge in to the field if you could more follow up on the patient by collecting more sample (both urine and fecal). Definitely, your finding would be interesting case report.
I've published a case of S. mansoni eggs in urine without hyper or super infection. As we all agree, this is quite uncommon, however, the high prevalence of such case is reported from Cameroon, where it was attributed to species hybridization.
I have found viable S. haematobium eggs in a rectal biopsy from a patient who had never been to a S. intercalatum endemic area and who was treated from urinary schistosomiasis about 20 years ago!!.
So. finding S..mansoni egg in urine or S. haematobium egg in stool are possible but rare cases. However, they should not necessarily be attributed to hybridization, also they may be attributed to ectopic infections or just uncommon mobilization of eggs by the circulatoy system..
what makes this issue important, that it points to a new trend for parasite tissue trafficking and localization. In a previous study (published in a conference) we identified 5% frequency of S. mansoni eggs in urine among study population at Al-Ozozab district (South Khartoum). Now we are trying molecular identification of these isolates.
Hi Kelvin, that is definitely possible. In Senegal, in an area were S. hematobium and S. mansoni are co-endemic, we have found the same. It is actually not that uncommon, certainly not if S. haematobium is also endemic. Is that the case in your area? Your observation then likely results from S. mansoni x S. haematobium worm pairs. When such mixed pairs are formed, the S. haematobium male carries the S. mansoni female worm to its location in the urinary/genital tract. Here the female will produce eggs that that look like S. mansoni eggs. It is not yet known whether the eggs are pure S. mansoni eggs, or whether they may have a mixed genetic constitution. If you are interested in this matter, please have a look at our papers! You will find all the references you may need.
yes , there are rare cases of mansoni eggs found in the urine. The eggs migrate to the bladder and cross it or may provoke granulomes.. You should read the recent publication by Meurs L, Mbow M, Vereecken K, Menten J, Mboup S, Polman K. Bladder morbidity and hepatic fibrosis in mixed Schistosoma haematobium and S. mansoni infections: a population-wide study in northern Senegal. Plos Neglected Tropical Diseases September 2012, 6(9):e1829.
I've actually seen this in a study we did on S.Haematobium in southern Côte d'Ivoire. And not even that rarely, Though I didn't note the frequency with which we found this cause my supervisor at the time told me that is a known and published fact. I kind of forgot about it then.
Will pay more attention to the frequency during our current study. Because it didn't seem to be as rare as is so often repeated here. I'm curious now.
The kidney is for Schistosoma mansoni an ectopic place,but eggs may be found.There is no description of worms in the literature.
Nevertheless,glomerulopathy,due to antibody-antigen complex may be presente.
thanks Meurs and others.
many more votes of thanks for your reference. I will definitely look at the paper because I wanted to know where to start for my case report!
By the way, my patient had both S.mansoni eggs in urine and S.haematobium adult worms found on a urine sample...so I am forced to believe that he had mixed infection but wondered why eggs of S.haematobium were not seen in the urine sample as well! Perhaps the adult worm (most likely the S.haematobium as the caeco-junction is close to the head?) was S.haematobium??!
I am now out of my country for a while but was considering the findings for a case report!
cheers!!!
This is common in countries where both S.haematobium & S.mansoni infections occur.
It was postulated that male S.haematobium worms can carry female S.mansoni worms & take them to the vesicle veins. Also, that the S.mansoni eggs in urine will not be mature or viable. They may also be found trapped in bladder tissues.
This was common in the Gezira area, Sudan, where both types of infection occur. Also, in some areas, S.haematobium infection was more prevalent than S.mansoni & then it reverse i.e. S.mansoi becomes more prevalent.
There are actually several reports in the literature that describe this occurrence, and the earlier ones are summarized in the review by Feldmeier et al (Genital manifestations of schistosomiasis mansoni in women: important but neglected). Interestingly, the presence of S. mansoni eggs in the genital tract has recently been postulated to be associated with increased HIV acquisition in Downs et al 2017 Negl Trop Dis., which also discussed the more recent reports of S. mansoni eggs in the genital mucosa seen in Tanzania.
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