Case report: Radiographic and cystoscopic manifestations of chronic urogenital Schistosomiasis in an asymptomatic Zimbabwean man with HIV

While undergoing evaluation for loss of consciousness and traumatic injuries after a single-vehicle collision, a 55-year-old Zimbabwean man residing in Maryland was incidentally noted to have circumferential bladder wall calcification and thickening on CT imaging. Cystoscopy revealed extensive ‘sandy patches’, confirmed by histopathology to represent calcified eggs of Schistosoma haematobium . Genitourinary symptoms were absent, ova were not identified on urine microscopy, and serum eosinophil level was normal, consistent with the primary infection having occurred at least 20 years prior. While structural and functional genitourinary abnormalities were absent, significant complications can occur even after years of asymptomatic disease.