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Worms in the bladder
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8/13/2017 at 12:00:05 AM GMT
Worms in the bladder

Dear all,

 

I have performed cystoscopy and bladder wall biopsy today on a patient who is 23 years old caucasian.

She presented with the LUTS and chronic pelvic pain.

I enclosed the pictures for your reference. It looks like a worm. For me this is the first time. Incidentally a South African Nurse straightaway told me that it is schistosmiasis. I biopsied the bladder with the white stuff (believed to be a worm).

 On specific enquiry, the patient says that she swam with her friends in Gingin Western Australia but the water was full of leaches, snails but might have worms. I believe Schistosmiasis is reported in Australia.

I have had a long discussion with this patient who swam in Swan River and a river near GIngin 2014-15. Since then she had several UTIs which are associated with haematuria and passing tissues.

 

My South Aftricam theatre nurse colleague was very confident about schistosomiasis as she spotted this on the first look.

 

However,, the biopsy suggests that she has BPS/IC but no evidence of any schistosomiasis, urine specimen - last fraction : No schistosomiasis.

 

I have commenced her on Amitryptiline and TMP at this time.

 

Please let me know your thoughts on this.

 

Best regards

 

Dr Arun

 


 Attached Images:

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