|LETTER TO EDITOR
|Year : 2015 | Volume
| Issue : 1 | Page : 68-69
Finding of an unusual ova - Schistosoma mansoni
Dhivyalakshmi Shanmugam1, Anupma J Kindo1, S Shanmughanathan2
1 Department of Microbiology, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, Tamil Nadu, India
2 Department of Gastroenterology , Sri Ramachandra Medical College and Research Institute, Porur, Chennai, Tamil Nadu, India
|Date of Web Publication||22-Jan-2015|
Anupma J Kindo
Department of Microbiology, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, Tamil Nadu
|How to cite this article:|
Shanmugam D, Kindo AJ, Shanmughanathan S. Finding of an unusual ova - Schistosoma mansoni
. Trop Parasitol 2015;5:68-9
Schistosomiasis is generally not seen in India. Here, we report a patient, a native of Nigeria who came to the outpatient department with the complaints of diarrhea. A request for routine stool examination for ova cyst was sent. To our surprise, we were able to see plenty of ova with lateral spines identifiable as eggs of Schistosoma mansoni [Figure 1].
|Figure 1: Saline mount showing multiple ova of Schistosoma mansoni (×10)|
Click here to view
Schistosomiasis is a major public health problem, with an estimated 200 million people infected, mostly in Africa.  It is endemic in 52 countries in Africa, South America, Caribbean Islands and Eastern Mediterranean. No case of S. mansoni has been reported so far from India.  S. mansoni is also known as Manson's blood fluke, which causes intestinal schistosomiasis or bilharziasis in humans producing lesions in the intestinal tract. Humans are the definitive host. On coming in close contact with stagnant water, they get infected by the cercaria (infective form in humans) piercing the intact skin causing swimmer's itch. Freshwater snails of genus Biomphalaria are the intermediate hosts. Eggs are the infective stage for snails. The infection is common in older children and adults; the prevalence is higher and intense among males when compared to females. This could be due to the outdoor activity seen more in young male adults. The clinical features may be highly variable depending upon the severity of the infection.  Here we are reporting a case of gastrointestinal schistosomiasis presenting with diarrhea in a foreigner studying in India [Figure 2].
The 26-year-old male student came as an outpatient with the complaints of loose stools since 4 days on and off with 1 week interval. He had no other symptoms like fever, abdominal discomfort, nausea or vomiting. On taking personal history, he mentioned about a recent visit to his native place, Nigeria for 1-month vacation. On enquiring about the type of activities he did there, he said that he went trekking and swimming.
The patient was asked for routine stool examination. On gross examination, the stool was semi-solid with no obvious blood or mucus. On microscopic examination of a wet saline mount, plenty of large oval shaped eggs were seen. The eggs were embryonated and measuring about 114-175 μm in length and 40-70 μm in breadth. The characteristic feature of the eggs was the presence of a sharp lateral spine. They were nonoperculated and yellowish brown in colour. Based on this, it was identified as ova of S. mansoni. On checking his HIV status, it was found to be negative.
Subsequently, he was put on praziquantel 25 mg/kg body weight 8 hourly. Repeat stool sample after treatment was negative for the eggs of the parasite. He was advised to maintain strict hygiene as he could be a potential source of contaminating the water bodies and spread infection to the community.
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[Figure 1], [Figure 2]