906 Schistosomiasis: The New ‘Gap Year’ Problem

Abstract Introduction Schistosomiasis is endemic in Africa, Asia, and South America. The parasite, found freshwater lakes, ultimately deposits eggs the veins around organs including bladder. It causes chronic inflammation resulting fibrosis of urogenital tract malignancy. In UK, cases schistosomiasis are unusual historically confined to immigrant population. patient We present case a British born 21-year-old who returned from round-the-world gap year. Upon return he reported dysuria, abdominal pain, poor flow, malaise. He was investigated for tropical diseases, treated recurrent urine infections, sexually transmitted infections before disclosing on direct questioning swimming Malawi. Cystoscopy demonstrated tight pan-urethral strictures. Sandy patches were seen throughout Histology bladder biopsy confirmed eggs. with Praziquantel. Despite treatment will likely require repeat urethral dilatations. Discussion Changes travel practice has led shift patients schistosomiasis. Clinicians should consider diagnosis anyone lower urinary symptoms visited or those diagnosed, clinicians have duty encourage them urge fellow swimmers seek urological input. Similarly travel-clinics be encouraged warn travellers against fresh-water prior travel. To avoid long term sequelae, prevention preferable, but early prompt intervention next best alternative. need low threshold suspect exclude this damaging diagnosis.