アフリカ滞在にて感染したビルハルツ住血吸虫症

Infection with schistosomal parasites in Africa

患者は25歳，女性。無症候性肉眼的血尿を主訴に受診。症状出現の数か月前にマラウィ湖での遊泳歴があった。膀胱鏡の所見ではbilharzial tuberclesを認め，尿中への虫卵の排泄も認められ，ビルハルツ住血吸虫症と診断。膀胱粘膜生検の病理結果では，虫卵や炎症による肉芽腫を認めた。治療はプラジカンテルの経口投与を2回施行した。治療開始11か月後膀胱鏡の所見は改善し，虫卵の尿中への排泄も認めず，治癒したと考えられる。

A 25-year-old Japanese woman with a history of travel to Africa visited our hospital complaining of intermittent asymptomatic gross hematuria for about six months. Urinary examination consisted of hematuria and pyuria. Further urine examination demonstrated eggs of schistosoma haematobium. Cystoscopy showed Bilharzial tubercles located in the urinary bladder. As she was suspected of being infested with schistosomal parasites based on her past history of swimming in Lake Malawi in Africa,transurethral resection of bladder tumors was performed. Pathological examination revealed granuloma with many eggs of schistosoma haematobium. She was diagnosed as Bilharzial schistosomiasis and was treated with praziquantel daily for two days. There have been no signs of recurrence,and no excretion of eggs of schistosoma haematobium in the urine for about 3 years.