Schistosomiasis is rare in Malaysia. It is of risk for patients who had history of having fresh water contact in the jungle. We present a case of which a middle-aged lady who presented with history of passing worm in the urine.
43 years old lady who was previously well presented to our centre with chief complaint of passing ‘worms’ in her urine. Apart from that she was well had no associated symptoms. She denied any recent history of traveling, jungle trekking or eating raw meat. Her vital signs were normal and no fever recorded. There was no abdomen distention or tenderness on examination. All other systems were normal on examination. She brought the worm which was small and red in colour. His full blood count was normal. Bedside ultrasound did not show any abnormalities in kidneys and bladder. She was subsequently referred to urology team. A working diagnosis of schistosomiasis was made. Patient was admitted by the urology team for urethroscope. Praziquantel was started or treatment. The urethroscope showed 3 more worms and they were removed. Patient was well with no more symptoms after that. She completed Praziquantel.Consultation with Parasitology department confirmed that the worm was ‘schistosoma’.
DISCUSSION & CONCLUSION
On top of being a rare presentation in Malaysia, this case is even more rare rarer without history of exposure to fresh water. It is prudent to keep the sample of the worm for confirmation and praziquantel may be started to eradicate the parasite.