Unusual presentation of schistosomiasis as vulval polyp
Keywords:
Schsistosomiasis, Vulva, Polyp
Abstract
Background: Schistosomiasis is a water borne disease caused by Schistosoma. It is the third most devastating tropical disease in the world, being a major source of morbidity and mortality for developing countries. Although the clinical manifestations on the urinary or gastrointestinal tracts are widely known, many clinical health-care professionals are unaware of the genital manifestations which are often ignored or underestimated.
Aim: To report a rare clinical manifestation of schistosomiasis in the form of vulval polyp and also to increase its awareness its presentation and management.
Case Report: An 11-year old pupil of presented to a peripheral hospital with 5-month history of progressive vulva swelling. She had no history of pain, itching, discharge or bleeding from the site. She had no urinary symptoms. The mass was clinically diagnosed as vulval polyp and surgically removed and sent for histology. She did well post operatively and was discharged to follow up in 2 weeks with the histology result. She was however lost to follow up. The histology results showed a granulomatous inflammation secondary to schistosomiasis.
Conclusion: Vulval schistosomiasis though rare should be suspected in a child with vulvo-vaginal swelling. Biopsy should be obtained before definitive treatment is instituted.
Downloads
Download data is not yet available.
References
1. Nour NM. Schistosomiasis: health effects on women. Rev Obstet Gynecol. 2010 Winter;3(1):28-32. [PubMed]
2. Schistosomiasis, Fact Sheet No 115; February 2010. World Health Organization. Available at http://www.who.int/mediacentre/factsheets/fs115/en/. Accessed: July 3, 2017.
3. Singh K, Muddasiru D, Singh J; Current status of schistosomiasis in Sokoto, Nigeria Parasite Epidemiology and Control, September 2016, Pages 239–244.
4. Weekly epidemiological record 30 April No.18,2010, 85(32): 157-164. World health Organization. Available at www.who.int/wer/2010/wer8532/en/ Accessed: July 3,2017.
5. Chistulo L, Loverde P, Engels D. Disease Watch: Schistosomiasis. TDR Nature Reviews Microbiology. 2004. 2:12-13.
6. Feldmeier H, Krantz I, Poggensee G. Female genital schistosomiasis as a risk-factor for the transmission of HIV. Int J STD AIDS. 1994 Sep-Oct;5(5):368-72.
7. King CH, Dangerfield-Cha M. The unacknowledged impact of chronic schistosomiasis. Chronic Illn. 2008 Mar;4(1):65-79. doi: 10.1177/1742395307084407. [PubMed]
8. Kjetland EF, Ndhlovu PD, Gomo E, Mduluza T, Midzi N, Gwanzura L, Mason PR, Sandvik L, Friis H, Gundersen SG. Association between genital schistosomiasis and HIV in rural Zimbabwean women. AIDS. 2006 Feb 28;20(4):593-600. [PubMed]
9. Secor WE, Shah A, Mwinzi PM, Ndenga BA, Watta CO, Karanja DM. Increased density of human immunodeficiency virus type 1 coreceptors CCR5 and CXCR4 on the surfaces of CD4+ T cells and monocytes of patients with Schistosoma mansoni infection. Infection and immunity. 2003 Nov 1;71(11):6668-71. [PubMed]
10. Siddappa NB, Hemashettar G, Shanmuganathan V, Semenya AA, Sweeney ED, Paul KS, Lee SJ, Secor WE, Ruprecht RM. Schistosoma mansoni enhances host susceptibility to mucosal but not intravenous challenge by R5 Clade C SHIV. PLoS Negl Trop Dis. 2011 Aug 2;5(8):e1270. [PubMed]
11. Tiboldi, T. Ovaries and adrenals in murine schistosomiasis mansoni. I. Histopathological changes of the ovaries in acute and chronic infection. Am. J. Trop. Med. Hyg. 1979;
28, 670–676.
12. Kjetland EF, Kurewa EN, Mduluza T, Midzi N, Gomo E, Friis H, Gundersen SG, Ndhlovu PD. The first community-based report on the effect of genital Schistosoma haematobium infection on female fertility. Fertil Steril. 2010 Sep;94(4):1551-3. doi: 10.1016/j.fertnstert.2009.12.050. Epub 2010 Feb 10.
13. Petry KU, Scholz U, Hollwitz B, Von Wasielewski R, Meijer CJ. Human papillomavirus, coinfection with Schistosoma hematobium, and cervical neoplasia in rural Tanzania. Int J Gynecol Cancer. 2003 Jul-Aug;13(4):505-9. [PubMed]
14. North M, Dubinchik I, Hamid A, Elderiny S, Sayegh R. Association between cervical schistosomiasis and cervical cancer. A report of 2 cases. J Reprod Med. 2003 Dec;48(12):995-8. [PubMed]
15. Shadab HA, Chief Editor: Michael SB; schistosomiasis, emedicine.medscape, updated oct 2016, accessed 27th April 2017.
16. Poggensee G, Feldmeier H, Krantz I. Schistosomiasis of the female genital tract: public health aspects. Parasitology today. 1999 Sep 1;15(9):378-81.
17. Oliveira FA, Soares VL, Dacal AR, Cavalcante FG, Mesquita AM, Fraga F, Lang K, Feldmeier H. Absence of cervical schistosomiasis among women from two areas of north–eastern Brazil with endemic Schistosoma mansoni. Annals of Tropical Medicine & Parasitology. 2006 Jan 1;100(1):49-54.
18. Qunhua L, Jiawen Z, Bozhao L, Zhilan P, Huijie Z, Shaoying W, Delun M, Hsu LN. Investigation of association between female genital tract diseases and Schistosomiasis japonica infection. Acta tropica. 2000 Nov 2;77(2):179-83.
19. Friedberg D, Berry AV, Schneider J. Schistosomiasis of the female genital tract. SAMJ. South African medical journal. 1991;80(3).
20. Swai B, Poggensee G, Mtweve S, Krantz I. Female genital schistosomiasis as an evidence of a neglected cause for reproductive ill-health: a retrospective histopathological study from Tanzania. BMC infectious diseases. 2006 Aug 23;6(1):134.
21. WHO, genital manifestation of schistosomiasis, a pocket atlas for clinical healthcare professionals 2017. Available at www.who.int/schistosomiasis/genitalschistosomiasis/en/ , accessed 3rd July, 2017.
22. Hoffmann, H. and Bauerfeind, I. High tissue egg burden mechanically impairing the tubal motility in genital schistosomiasis of the female. Acta Obstet. Gynecol. Scand. 2003; 82, 970–971
23. Leutscher P, Ravaoalimalala VE, Raharisolo C, Ramarokoto CE, Rasendramino M, Raobelison A, Vennervald B, Esterre P, Feldmeier H. Clinical findings in female genital schistosomiasis in Madagascar. Trop Med Int Health. 1998 Apr;3(4):327-32.
24. Kjetland EF, Kurewa EN, Ndhlovu PD, Midzi N, Gwanzura L, Mason PR, Gomo E, Sandvik L, Mduluza T, Friis H, Gundersen SG. Female genital schistosomiasis–a differential diagnosis to sexually transmitted disease: genital itch and vaginal discharge as indicators of genital Schistosoma haematobium morbidity in a cross‐sectional study in endemic rural Zimbabwe. Tropical Medicine & International Health. 2008 Dec 1;13(12):1509-17.
25. Charlewood GP, Shippel S, Renton H. Schistosomiasis in gynaecology. J Obstet Gynaecol Br Emp. 1949 Jun;56(3):367-85. [PubMed]
26. Al-Adnani MS, Saleh KM. Extraurinary schistosomiasis in Southern Iraq. Histopathology. 1982 Nov;6(6):747-52. [PubMed]
27. Bellingham FR. Genital bilharzia: a report of 3 cases. Aust N Z J Obstet Gynaecol. 1972 Nov;12(4):267-8
28. Savioli L, Gabrielli A, Neve H. Vulvar Schistosoma haematobium lesion treated with praziquantel. Tropical doctor. 1990;20(1):45-6.
9. O'Mahony D, Banach L, La Grange LL. A case of vulval schistosomiasis. South African Family Practice. 2007;49(9):42-3.
30. Kjetland EF, Leutscher PD, Ndhlovu PD. A review of female genital schistosomiasis. Trends Parasitol. 2012 Feb;28(2):58-65. doi: 10.1016/j.pt.2011.10.008. Epub 2012 Jan 12. [PubMed]
2. Schistosomiasis, Fact Sheet No 115; February 2010. World Health Organization. Available at http://www.who.int/mediacentre/factsheets/fs115/en/. Accessed: July 3, 2017.
3. Singh K, Muddasiru D, Singh J; Current status of schistosomiasis in Sokoto, Nigeria Parasite Epidemiology and Control, September 2016, Pages 239–244.
4. Weekly epidemiological record 30 April No.18,2010, 85(32): 157-164. World health Organization. Available at www.who.int/wer/2010/wer8532/en/ Accessed: July 3,2017.
5. Chistulo L, Loverde P, Engels D. Disease Watch: Schistosomiasis. TDR Nature Reviews Microbiology. 2004. 2:12-13.
6. Feldmeier H, Krantz I, Poggensee G. Female genital schistosomiasis as a risk-factor for the transmission of HIV. Int J STD AIDS. 1994 Sep-Oct;5(5):368-72.
7. King CH, Dangerfield-Cha M. The unacknowledged impact of chronic schistosomiasis. Chronic Illn. 2008 Mar;4(1):65-79. doi: 10.1177/1742395307084407. [PubMed]
8. Kjetland EF, Ndhlovu PD, Gomo E, Mduluza T, Midzi N, Gwanzura L, Mason PR, Sandvik L, Friis H, Gundersen SG. Association between genital schistosomiasis and HIV in rural Zimbabwean women. AIDS. 2006 Feb 28;20(4):593-600. [PubMed]
9. Secor WE, Shah A, Mwinzi PM, Ndenga BA, Watta CO, Karanja DM. Increased density of human immunodeficiency virus type 1 coreceptors CCR5 and CXCR4 on the surfaces of CD4+ T cells and monocytes of patients with Schistosoma mansoni infection. Infection and immunity. 2003 Nov 1;71(11):6668-71. [PubMed]
10. Siddappa NB, Hemashettar G, Shanmuganathan V, Semenya AA, Sweeney ED, Paul KS, Lee SJ, Secor WE, Ruprecht RM. Schistosoma mansoni enhances host susceptibility to mucosal but not intravenous challenge by R5 Clade C SHIV. PLoS Negl Trop Dis. 2011 Aug 2;5(8):e1270. [PubMed]
11. Tiboldi, T. Ovaries and adrenals in murine schistosomiasis mansoni. I. Histopathological changes of the ovaries in acute and chronic infection. Am. J. Trop. Med. Hyg. 1979;
28, 670–676.
12. Kjetland EF, Kurewa EN, Mduluza T, Midzi N, Gomo E, Friis H, Gundersen SG, Ndhlovu PD. The first community-based report on the effect of genital Schistosoma haematobium infection on female fertility. Fertil Steril. 2010 Sep;94(4):1551-3. doi: 10.1016/j.fertnstert.2009.12.050. Epub 2010 Feb 10.
13. Petry KU, Scholz U, Hollwitz B, Von Wasielewski R, Meijer CJ. Human papillomavirus, coinfection with Schistosoma hematobium, and cervical neoplasia in rural Tanzania. Int J Gynecol Cancer. 2003 Jul-Aug;13(4):505-9. [PubMed]
14. North M, Dubinchik I, Hamid A, Elderiny S, Sayegh R. Association between cervical schistosomiasis and cervical cancer. A report of 2 cases. J Reprod Med. 2003 Dec;48(12):995-8. [PubMed]
15. Shadab HA, Chief Editor: Michael SB; schistosomiasis, emedicine.medscape, updated oct 2016, accessed 27th April 2017.
16. Poggensee G, Feldmeier H, Krantz I. Schistosomiasis of the female genital tract: public health aspects. Parasitology today. 1999 Sep 1;15(9):378-81.
17. Oliveira FA, Soares VL, Dacal AR, Cavalcante FG, Mesquita AM, Fraga F, Lang K, Feldmeier H. Absence of cervical schistosomiasis among women from two areas of north–eastern Brazil with endemic Schistosoma mansoni. Annals of Tropical Medicine & Parasitology. 2006 Jan 1;100(1):49-54.
18. Qunhua L, Jiawen Z, Bozhao L, Zhilan P, Huijie Z, Shaoying W, Delun M, Hsu LN. Investigation of association between female genital tract diseases and Schistosomiasis japonica infection. Acta tropica. 2000 Nov 2;77(2):179-83.
19. Friedberg D, Berry AV, Schneider J. Schistosomiasis of the female genital tract. SAMJ. South African medical journal. 1991;80(3).
20. Swai B, Poggensee G, Mtweve S, Krantz I. Female genital schistosomiasis as an evidence of a neglected cause for reproductive ill-health: a retrospective histopathological study from Tanzania. BMC infectious diseases. 2006 Aug 23;6(1):134.
21. WHO, genital manifestation of schistosomiasis, a pocket atlas for clinical healthcare professionals 2017. Available at www.who.int/schistosomiasis/genitalschistosomiasis/en/ , accessed 3rd July, 2017.
22. Hoffmann, H. and Bauerfeind, I. High tissue egg burden mechanically impairing the tubal motility in genital schistosomiasis of the female. Acta Obstet. Gynecol. Scand. 2003; 82, 970–971
23. Leutscher P, Ravaoalimalala VE, Raharisolo C, Ramarokoto CE, Rasendramino M, Raobelison A, Vennervald B, Esterre P, Feldmeier H. Clinical findings in female genital schistosomiasis in Madagascar. Trop Med Int Health. 1998 Apr;3(4):327-32.
24. Kjetland EF, Kurewa EN, Ndhlovu PD, Midzi N, Gwanzura L, Mason PR, Gomo E, Sandvik L, Mduluza T, Friis H, Gundersen SG. Female genital schistosomiasis–a differential diagnosis to sexually transmitted disease: genital itch and vaginal discharge as indicators of genital Schistosoma haematobium morbidity in a cross‐sectional study in endemic rural Zimbabwe. Tropical Medicine & International Health. 2008 Dec 1;13(12):1509-17.
25. Charlewood GP, Shippel S, Renton H. Schistosomiasis in gynaecology. J Obstet Gynaecol Br Emp. 1949 Jun;56(3):367-85. [PubMed]
26. Al-Adnani MS, Saleh KM. Extraurinary schistosomiasis in Southern Iraq. Histopathology. 1982 Nov;6(6):747-52. [PubMed]
27. Bellingham FR. Genital bilharzia: a report of 3 cases. Aust N Z J Obstet Gynaecol. 1972 Nov;12(4):267-8
28. Savioli L, Gabrielli A, Neve H. Vulvar Schistosoma haematobium lesion treated with praziquantel. Tropical doctor. 1990;20(1):45-6.
9. O'Mahony D, Banach L, La Grange LL. A case of vulval schistosomiasis. South African Family Practice. 2007;49(9):42-3.
30. Kjetland EF, Leutscher PD, Ndhlovu PD. A review of female genital schistosomiasis. Trends Parasitol. 2012 Feb;28(2):58-65. doi: 10.1016/j.pt.2011.10.008. Epub 2012 Jan 12. [PubMed]
CITATION
DOI: 10.17511/joog.2017.i04.01
Published: 2017-12-31
How to Cite
M. Sahabi, S., & F. Rabiu, A. (2017). Unusual presentation of schistosomiasis as vulval polyp. Obs Gyne Review: Journal of Obstetric and Gynecology, 3(4), 33-37. https://doi.org/10.17511/joog.2017.i04.01
Section
Case Report
Copyright (c) 2017 Author (s). Published by Siddharth Health Research and Social Welfare Society
This work is licensed under a Creative Commons Attribution 4.0 International License.
OAI - Open Archives Initiative
Therapoid
