Urinary schistosomiasis is one of the main public health problems in Africa and the Middle East. Schistosomiasis (Bilharziasis) seems to be on the rise in developed countries like United Kingdom with the continuing influx of immigrants and refugees, as well as the return of travellers and soldiers from endemic areas.
We present case report from UK, of a 14 year old Asian boy, who presented to a general paediatrician with a two month history of painless, gross, terminal haematuria. He also had general symptoms of malaise, early fatigability with poor appetite and was a known carrier of thalassemia trait.
On Full blood count, his haemoglobin was 11.4 gm/dl with eosinophilia 0.71×109 (Normal range 0.04-0.40). An ultrasound scan of urinary tract revealed localised thickening of bladder located towards the trigone. This raised suspicion of rhabdomyosarcoma of bladder.
An urgent cystoscopy was performed which revealed multiple lesions in the area of trigone, studded with white spots within the lesion. Punch biopsy was done which showed eggs of Schistosomia haematobium and the inflammatory mass constituted eosinophilic infiltration.
History was revisited and it was discovered that he had travelled to Malawi, where his father was working. As a treatment two doses of Praziquantel was given and patient will be followed up with ultrasound scan later to assess the bladder lesions.