Isolation of Schistosoma haematobium in Bronchoalveolar Lavage in an Immunocompromised Individual: A Case Report

Abstract

Schistosomiasis is a parasitic disease caused by trematodes (body flukes), affecting millions worldwide. However, its pulmonary manifestations are rare. We report a rare case of a 51-year-old People Living with HIV male, managed in a tertiary care hospital in west India in May 2023, vegetable vendor who was admitted with complaints of dysphagia, odynophagia, fever and chest pain for 3 days, cough and breathlessness for 1 month. Chest x-ray and CT scan were suggestive of hypodense fluid collection with rim enhancement along right lateral and posterior aspect of thoracic esophagus. All routine investigations and urine cultures were sent, which turned to be inconclusive. Upper Gastrointestinal scopy was suggestive of pangastritis. Fiberoptic bronchoscopy was done with no structural abnormality or endobronchial mass. Bronchoalveolar lavage from right lower lobe was sent for CBNAAT, Gram and Ziehl Nelson staining and cultures, acid fast bacilli cultures and cytology which revealed parasitic infection with Schistosoma haematobium. The patient was treated with tablet praziquantel P/O 2400 mg in divided doses for 1 day followed up after two weeks when he experienced reduced symptoms. Sputum examination was repeated showed Schistosoma on wet mount and hence a repeat dose of tablet praziquantel 3000 mg in divided doses was given and was advised to follow up 2 weeks later, which showed resolution of right lower zone opacities.