Hostname: page-component-77f85d65b8-g4pgd Total loading time: 0 Render date: 2026-04-20T05:33:12.967Z Has data issue: false hasContentIssue false
  • English
  • Français

Description of four cases of male genital schistosomiasis (MGS) in children and adolescents, with a scoping review

Published online by Cambridge University Press:  24 February 2025

Joachim Richter Open the ORCID record for Joachim Richter [Opens in a new window] ,
Sekeleghe A. Kayuni ,
J. Russell Stothard Open the ORCID record for J. Russell Stothard [Opens in a new window] ,
Charles Émile Ramarokoto ,
Andreas K. Lindner ,
Daniela Fusco ,
Hermann Feldmeier ,
Amaya L. Bustinduy Open the ORCID record for Amaya L. Bustinduy [Opens in a new window]  and
Jennifer F. Friedman
Joachim Richter*
Affiliation:
Institute of International Health, Global Health Center, Charité Universitätsmedizin, Corporate Member of Free University and Humboldt University and Berlin Institute of Health, Berlin, Germany Centre for Tropical and Travel Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland
Sekeleghe A. Kayuni
Affiliation:
Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
J. Russell Stothard
Affiliation:
Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
Charles Émile Ramarokoto
Affiliation:
Epidemiology Unit, Institut Pasteur, Antananarivo, Madagascar
Andreas K. Lindner
Affiliation:
Institute of International Health, Global Health Center, Charité Universitätsmedizin, Corporate Member of Free University and Humboldt University and Berlin Institute of Health, Berlin, Germany
Daniela Fusco
Affiliation:
Implementation Research Group, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
Hermann Feldmeier
Affiliation:
Institute of Microbiology, Charité Universitätsmedizin, Corporate Member of Free University and Humboldt University and Berlin Institute of Health, Berlin, Germany
Amaya L. Bustinduy
Affiliation:
Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
Jennifer F. Friedman
Affiliation:
Lifespan Center for International Health Research (CIHR), Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, USA
*
Corresponding author: Joachim Richter; Email: jockelri@gmail.com
Rights & Permissions [Opens in a new window]

Abstract

We present four cases of male genital schistosomiasis (MGS) within children and adolescents opportunistically encountered as part of a wider screening programme for imported schistosomiasis in Germany and community outreach screening in Mali. Such genital manifestations in young children and adolescents are often overlooked but can include hydrocele, hypogonadism, varicocele, cutaneous granulomata on the penis and scrotum, echogenic spots in the prostate and the epididymis, alongside testicular masses. Though these cases appear sporadic, from our scoping literature review, they draw fresh attention on MGS in young children and highlight wider confusion with other congenital, neoplastic and infectious disease. These might include an insufficient closure of the tunica vaginalis, malignancies or lymphatic filariasis. Frequently haematuria is not present. One typical sign indicating MGS in adults, i.e. haematospermia is not present before puberty. Another reason of missing MGS cases may be that screening with scrotal or transabdominal ultrasonography are not easily accepted unless the reason for it is not extensively explained beforehand and that transabdominal ultrasonography is less sensitive for revealing prostatic lesions than transrectal ultrasonography.

Keywords

adolescentschildrenhydrocelehypogonadismmale genital schistosomiasisminorsSchistosomaschistosomiasistesticular massesultrasound

Information

Type
Review Article
Information
Parasitology , Volume 152 , Special Issue 14: Parasites of the genital tract: short- and long-term consequences , December 2025 , pp. 1436 - 1445
Check for updates
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press.

Introduction

Schistosomiasis is a neglected parasitic infection caused by blood fluke trematodes of the genus Schistosoma. Four out of six Schistosoma species pathogenic to humans have been described as being capable of inducing disease sequelae within the genital tract: S. haematobium; causing urogenital schistosomiasis, S. mansoni, S. intercalatum, and S. japonicum; mainly causing intestinal and hepatosplenic schistosomiasis (Lee et al., Reference Lee, Hsueh and Tang2000; Shekhar et al., Reference Shekhar, Soh and Jayalakshmi2000; Yu et al., Reference Yu, Wei, Wang, Ye, Wang, Chen, Ni, Yang, Gui, Guan, Cai and Lai2013; Bustinduy et al., Reference Bustinduy, Richter and King2023). Recently, the zoonotic species S. matthei has also been found to cause human genital schistosomiasis (Kayuni et al.,Reference Kayuni, Cunningham, Kumwenda, Mainga, Lally, Chammudzi, Kapira, Namacha, Ntaba, Chisale, Nchembe, Kinley, Chibwana, Juhasz, Jones, Archer, Makaula, Chiphwanya, LaCourse, Musaya and Stothard2024). Globally, approximately 240 million people are infected (about 90% living in sub-Saharan Africa) (WHO 2020). Health complications arising from genital schistosomiasis have been more and more acknowledged, especially those occurring in women (Abul Kahir et al. Reference Abul-Khair, Sobeih, Taalab and Taalab1980; Richter et al., Reference Richter, Poggensee, Helling-Giese, Kjetland, Chitsulo, Koumenda, Gundersen, Krantz and Feldmeier1995, Reference Richter, Poggensee, Kjetland, Helling-Giese, Chitsulo, Kumwenda, Gundersen, Deelder, Reimert, Haas, Krantz and Feldmeier1996, Reference Richter, Lux, Reinecke and Müller-Mattheis2008; Kjetland et al., Reference Kjetland, Poggensee, Helling-Giese, Richter, Sjaastad, Chitsulo, Kumwenda, Gundersen, Krantz and Feldmeier1996; Helling Giese et al., Reference Helling-Giese, Kjetland, Gundersen, Poggensee, Richter, Krantz and Feldmeier1996a; Helling-Giese et al., Reference Helling-Giese, Sjaastad, Poggensee, Kjetland, Richter, Chitsulo, Kumwenda, Roald, Gundersen, Krantz and Feldmeier1996b; Poggensee et al., Reference Poggensee, Sikelu, Saría, Richter, Krantz and Feldmeier1998; Schanz et al., Reference Schanz, Richter, Beyer, Baldus, Hess and Kruessel2010; Christinet et al., Reference Christinet, Lazdins-Helds, Stothard and Reinhard-Rupp2016; Kayuni et al. Reference Kayuni, Lampião, Makaula, Juziwelo, Lacourse, Reinhard-Rupp, Leutscher and Stothard2020; Kayuni et al., Reference Kayuni, Cunningham, Kumwenda, Mainga, Lally, Chammudzi, Kapira, Namacha, Ntaba, Chisale, Nchembe, Kinley, Chibwana, Juhasz, Jones, Archer, Makaula, Chiphwanya, LaCourse, Musaya and Stothard2024; World Health Organization, 2020; Bustinduy et al., Reference Bustinduy, Randriansolo, Sturt, Kayuni, Leustcher, Webster, Van Lieshout, Stothard, Feldmeier and Gyapong2022; Fusco et al., Reference Fusco, Martínez-Pérez, Remkes, De Pascali, Ortalli, Varani and Scagliarini2022; Kutz et al., Reference Kutz, Rausche, Rasamoelina, Ratefiarisoa, Razafindrakoto, Klein, Jaeger, Rakotomalala, Rakotomalala, Randrianasolo, McKay-Chopin, May, Rakotozandrindrainy, Puradiredja, Sicuri, Hampl, Lorenz, Gheit, Rakotoarivelo and Fusco2023; Shanaube et al., Reference Shanaube, Ndubani, Kelly, Webb, Mayaud, Lamberti, Fitzpatrick, Kasese, Sturt, Van Lieshout, Van Dam, Corstjens, Kosloff, Bond, Hayes, Terris-Prestholt, Webster, Vwalika, Hansingo, Ayles and Bustinduy2024). However, little is known about the frequency of genital manifestations of schistosomiasis in younger children and adolescents, particularly in males. To shed light on the latter, we report on four cases of MGS in male children and adolescents, and place these cases within a wider appraisal of available literature.

Ethical considerations

Mandatory routine infectious and parasitic diseases screening of unaccompanied minor refugees (UMR) arriving in Berlin is performed at the Institute of Tropical Medicine and International Health of Charité – Universitätsmedizin Berlin, and previous findings have been described in detail elsewhere (Theuring et al., Reference Theuring, Friedrich-Jänicke, Pörtner, Trebesch, Durst, Dieckmann, Steiner, Harms and Mockenhaupt2016).

Case reports

Case 1

A 4-year-old boy, son of German volunteers living in Tanzania for 2 years, had intermittent non-febrile bloody diarrhoea for 5 months. After returning to Germany he was examined and presented with a painless swelling of the scrotum and livid skin discoloration, with congestion of the dorsal vein of the penis, accompanied by tenderness and swelling of two inguinal lymph nodes. At interview the parents recalled that he used to play near a river in Tanzania; they remembered no trauma. The diagnosis of schistosomiasis was confirmed by faecal microscopy, where viable ova of S. mansoni were found. Urinary sediment was normal; Schistosoma ova were not detected by microscopy of urine collected over 24 h with the whole volume filtered through microfilters (Nucleopore, Corning, Acton, USA). A differential white blood cell count showed eosinophilia (10%, 600 µL−1). Serology for anti-Schistosoma antibodies (anti-adult worm antibodies, an immune-haemagglutination assay) was highly positive. Amoebiasis, filariasis, toxocariasis and urogenital tuberculosis were excluded by clinical, parasitological, serological and ultrasonography means and antigen testing for Wuchereria bancrofti (Amaral et al., Reference Amaral, Dreyer, Figueredo-Silva, Noroes, Cavalcanti, Samico, Santos and Coutinho1994, Chung et al., Reference Chung, Kim, Lee, Voo and Lee1997, Weil et al., Reference Weil, Lammie and Weiss1997). On abdominal ultrasonography, he had nonspecific hepatosplenomegaly, as encountered in the early stages of the disease (Barata et al., Reference Barata, Pinto-Silva and Lambertucci1999) but without typical signs of schistosomal hepatic fibrosis (Richter et al., Reference Richter, Zwingenberger, Mohamed-Ali, Moura Lima, Dacal, Vergetti Siqueira, Doehring-Schwerdtfeger and Feldmeier1992). No abnormalities of the urinary tract were detected (Niamey Working Group, Reference Richter, Hatz, Campagne and Jenkins2000). Scrotal ultrasonography showed an echo-free fluid in the scrotum; the testis, epididymis, prostate and seminal vesicles were normal (Figure 1). A consultant paediatric urologist interpreted these findings as due to a patent processus vaginalis and recommended surgical division of the processus. However, more invasive investigations were declined by the boy’s parents because we suspected a causal relation between schistosomiasis and the boy’s hydrocele. He was treated with one standard dose of praziquantel at 40 mg kg−1 and surgery was postponed. The treatment was repeated at the same dose over 2 days 8 weeks later, owing to the detection of viable ova still being excreted in the stool; 16 weeks after therapy Schistosoma ova were absent in the faeces. The hydrocele had disappeared and remained so during the following 12 months, when the boy was last reviewed.

Figure 1. Two-year-old German boy with Schistosoma mansoni infection, who had grown up in Kenya and Tanzania. Scrotal swelling and ultrasonography showing hydrocele before (1a, 1b) and six weeks after praziquantel (1c, 1d).

Case 2

Unaccompanied minor refugees are routinely screened in our outpatient clinic. Here, we attended a 17-year-old male Fulani adolescent from Sierra Leone. He had been treated successfully for disseminated tuberculosis a year earlier. At his presentation in our OPD, his differential blood count revealed an eosinophilia of 1.1 nl−1 (norm < 0.5) and IgE was increased to 4646 ku l−1 (norm < 100). Serology revealed positive antibodies against filariae, Strongyloides stercoralis and schistosomes. Microscopy of microfiltered urine collected during 24 h did not reveal the presence of helminths or their ova. Microscopy of four skin snips and of anticoagulated full blood microfiltered through a nuclepore filter at lunchtime and after provocation with di-ethyl-carbamazine were all negative. Microscopy of enriched fresh stool samples for helminth larvae according to the Baermann method was negative for worm larvae but instead, ova of S. mansoni were found. The patient was initially seen by a female doctor. At the second visit he asked for being seen by a male doctor because he was ashamed to report a recurrent scrotal swelling with disappearance of his penis inside the swollen scrotum. Ultrasonography of the scrotum revealed a hydrocele of the right scrotum and to a lower degree of the left side (Figure 2). Adult filariae (‘filarial dance sign’) were not detected in the scrotal lymphatics (Al-Saeed et al., Reference Al-Saeed, Figueiredo-Silva and Noroes1994). Therapy with ivermectin 200 μg kg−1 was given and repeated after two weeks followed by praziquantel three doses of 40 mg kg−1 body weight. Since during the 12 months following antiparasitic therapy the hydrocele persisted, surgical therapy was performed in order to completely cure his hydrocele.

Figure 2. Scrotal ultrasonography of a 17-year-old Fulani refugee from Guinea Conakry with Schistosoma mansoni infection. Right testis immerged in anechoic scrotal fluid.

We cannot exclude that the aetiology of hydrocele in his case was multifactorial. He had been cured in the past from disseminated tuberculosis and had probably been previously infected by filariae as proven by positive antibodies against filariae. The moment he was attended in our service, he suffered from active schistosomiasis. Anti-helminthic alone was not sufficient for curing his hydrocele, so that we opted for additional surgical therapy which was finally successful. The patient was well until three years later, when he was last reviewed.

Case 3

During a training course on ultrasonography in urinary schistosomiasis in Mali 25 children were selected, 13 of whom (52%) excreted ova of S. haematobium in urine. Among the children one 12-year-old boy was identified by ultrasonography who presented a hyperechogenic spot measuring 7× .4 × 4 mm in the right prostate lobe (Figure 3). Microfiltration of noon urine revealed a quantitative egg excretion of 11 eggs/10 ml urine. Findings of seminal vesicles, urethers and kidneys were unremarkable. The patient was treated by praziquantel with a single standard dose of 40 mg kg−1 body weight. The patient was lost to follow-up.

Figure 3. Hyperechoic spot in the prostate of a 12-year-old boy from Mali with S. haematobium infection.

Case 4

This case was seen among other minor refugees to Germany from Guinée Conakry, presenting with a hydrocele which reversed after three doses of praziquantel at 40 mg kg−1. Details are described in Table 1.

Literature search

Literature search was performed in several data bases including PubMed, Medline, Cochrane, Google scholar and Embase with the search terms ‘Male genital schistosomiasis AND child, children’ and ‘Male genital schistosomiasis AND adolescent/adolescents’. The selection process of eligible publications is shown in.

Discussion

The importance of genital manifestations in women and men has been increasingly acknowledged during the last 30 years (Richter et al., Reference Richter, Poggensee, Helling-Giese, Kjetland, Chitsulo, Koumenda, Gundersen, Krantz and Feldmeier1995, Reference Richter, Poggensee, Kjetland, Helling-Giese, Chitsulo, Kumwenda, Gundersen, Deelder, Reimert, Haas, Krantz and Feldmeier1996, Reference Richter, Lux, Reinecke and Müller-Mattheis2008; Kjetland et al., Reference Kjetland, Poggensee, Helling-Giese, Richter, Sjaastad, Chitsulo, Kumwenda, Gundersen, Krantz and Feldmeier1996; Helling Giese et al., Reference Helling-Giese, Kjetland, Gundersen, Poggensee, Richter, Krantz and Feldmeier1996a; Helling-Giese et al., Reference Helling-Giese, Sjaastad, Poggensee, Kjetland, Richter, Chitsulo, Kumwenda, Roald, Gundersen, Krantz and Feldmeier1996b; Leutscher et al. Reference Leutscher, Pedersen, Raharisolo, Jensen, Hoffmann, Lisse, Ostrowski, Reimert, Mauclere and Ullum2005; Schanz et al., Reference Schanz, Richter, Beyer, Baldus, Hess and Kruessel2010; Christinet et al., Reference Christinet, Lazdins-Helds, Stothard and Reinhard-Rupp2016; Kayuni et al., Reference Kayuni, Lampião, Makaula, Juziwelo, Lacourse, Reinhard-Rupp, Leutscher and Stothard2018; World Health Organization, 2020; Bustinduy et al., Reference Bustinduy, Randriansolo, Sturt, Kayuni, Leustcher, Webster, Van Lieshout, Stothard, Feldmeier and Gyapong2022; Fusco et al., Reference Fusco, Martínez-Pérez, Remkes, De Pascali, Ortalli, Varani and Scagliarini2022; Kutz et al., Reference Kutz, Rausche, Rasamoelina, Ratefiarisoa, Razafindrakoto, Klein, Jaeger, Rakotomalala, Rakotomalala, Randrianasolo, McKay-Chopin, May, Rakotozandrindrainy, Puradiredja, Sicuri, Hampl, Lorenz, Gheit, Rakotoarivelo and Fusco2023; Shanaube et al., Reference Shanaube, Ndubani, Kelly, Webb, Mayaud, Lamberti, Fitzpatrick, Kasese, Sturt, Van Lieshout, Van Dam, Corstjens, Kosloff, Bond, Hayes, Terris-Prestholt, Webster, Vwalika, Hansingo, Ayles and Bustinduy2024).

However, knowledge on the importance of genital schistosomiasis in children and adolescents is scarce although genital schistosomiasis in a young boy has been described for the first time by Madden already in 1911. (Madden, Reference Madden1911; Feldmeier et al., Reference Feldmeier, Richter, Helling-Giese and Krantz1995; Bustinduy et al., Reference Bustinduy, Randriansolo, Sturt, Kayuni, Leustcher, Webster, Van Lieshout, Stothard, Feldmeier and Gyapong2022; Aribodor et al., Reference Aribodor, Azugo, Jacob, Ngenegbo, Onwusulu, Obika, Obikwelu and Nebe2024). There has never been a systematic investigation on the importance of genital manifestations at a young age. We came across four cases; two of them observed during health screening of unaccompanied minor refugees to Germany. To our knowledge, our case 1 is the youngest case of genital schistosomiasis age ever reported in the literature (Richter et al., Reference Richter, Stegemann and Häussinger2002). Another case of penile schistosomiasis has been reported to one of our authors (B. Quire personal communication to AL Bustinduy). Surprisingly, besides our cases, we have found only other 23 cases published worldwide since 1911. Other publications on patient series with MGS have been published but it is not possible to understand from the publications whether or not minors included in the cohorts had MGS manifestations (Alves et al., Reference Alves, Woods and Gelfand1955; Gelfand et al. Reference Gelfand and Davis1940; De Souza et al. Reference De Souza Alves, Assis and Rezende2004; Aminu et al. Reference Aminu, Ibrahim, Nasiru and Isaac2023; Mohammed et al., Reference Mohammed, Edino and Samaila2007; Ramarokoto et al., Reference Ramarokoto, Leutscher, van Dam and Christensen2008; Msyamboza et al., Reference Msyamboza, Ngwira, Banda, Mkwanda and Brabin2010; Percheron et al., Reference Percheron, Leblanc, Ulinski, Fila, Malvy, Bacchetta, Guigonis, Debuisson, Launay, Martinez, Morand, Decramer, Schanstra and Berry2024). The relative scarcity of cases published in the literature points at underreporting. One possible reason is that only a minority of patients present with haematuria. In our case series, only 3/27 (11.11%) cases reported haematuria. Another indicative sign of MGS, i.e. haematospermia and changes of the consistence of ejaculate cannot be investigated before puberty (Corachan et al., Reference Corachan, Valls, Gascon, Almeda and Vilana1994; McKenna et al., Reference McKenna, Schousboe and Paltridge1997; van Delft et al., Reference van Delft, Visser, Polderman and van Lieshout2007). A third reason is possibly that MGS may occur without the presence of schistosome ova in urine (Richter et al., Reference Richter, Stegemann and Häussinger2002; van Delft et al., Reference van Delft, Visser, Polderman and van Lieshout2007). A fourth reason may possibly be that the condition is not well known to urologists. 24/27 (88.89%) cases of our series were diagnosed by accident when another cause was suspected such as a malignancy (see Table 1). Even in endemic countries urologists usually do not connect genital problems with schistosomiasis and even less so, when it occurs in children or adolescents. In endemic countries, hydrocele is most frequently ascribed to filariasis. Interestingly, contrary to current notions, in an Egyptian and In a Sudanese case series on histopathological samples collected during scrotal surgery, schistosomiasis was the cause of scrotal swellings more frequently than filariasis (Abdel Wahab et al., Reference Abdel Wahab, Shoeb, Haseeb, Sherif, El-deeb, El-fiky and El-beshlawy1981; Malik et al. Reference Malik and Ibrahim1982). A fifth possible biasing cause is the fact that the patients and their parents are ashamed of their condition which, on the other hand, appears to be painless and not immediately threatening. In fact, in our cases with hydrocele, the patients had never reported spontaneously their ailment to the medical staff at the first visit and mostly asked later to be seen by a male doctor.

In adults, genital involvement is particularly frequent condition in infections by S. haematobium and to a lesser extent S. intercalatum (Corachan et al., Reference Corachan, Escosa, Mas, Ruiz and Campo1987; Picaud et al., Reference Picaud, Walter, Bennani, Minko Mi Etoua and Nlome Nze1990; Jusot et al., Reference Jusot, Simarro and De Muynck1997; Leutscher et al., Reference Leutscher, Ramarokoto, Reimert, Feldmeier, Esterre and Vennervald2000; van Delft et al., Reference van Delft, Visser, Polderman and van Lieshout2007; Ramarokoto et al., Reference Ramarokoto, Leutscher, van Dam and Christensen2008; Kayuni et al., Reference Kayuni, Lampião, Makaula, Juziwelo, Lacourse, Reinhard-Rupp, Leutscher and Stothard2018) but genital schistosomiasis has been reported to occur also in S. mansoni, S. japonicum and S. matthei infections (Kayuni et al.Reference Kayuni, Cunningham, Kumwenda, Mainga, Lally, Chammudzi, Kapira, Namacha, Ntaba, Chisale, Nchembe, Kinley, Chibwana, Juhasz, Jones, Archer, Makaula, Chiphwanya, LaCourse, Musaya and Stothard2024; Steinberger et al., Reference Steinberger, Lindsay, Alassandri and Wise1975; Armbrust, Reference Armbrust1951; Steinberger et al., Reference Steinberger, Lindsay, Alassandri and Wise1975; Bambirra et al., Reference Bambirra, de Souza Andrade, Bamberg, Costa, Andrade and de Souza1986; Lee et al., Reference Lee, Hsueh and Tang2000; Shekhar et al., Reference Shekhar, Soh and Jayalakshmi2000; de Souza Alves et al. Reference Cassio Saito, de Barros, Chammas, Oliveira and Cerri2004; Cassio Saito et al., Reference Cassio Saito, de Barros, Chammas, Oliveira and Cerri2004; Neto et al., Reference Neto, Grande and Moreira2004; Lopes et al., Reference Lopes, de Almeida and Jacobino2007a, Reference Lopes, Leite, Prando and Lopes2007b; Ricosse et al., Reference Ricosse, Emeric and Courbil1980; Schwartz et al., Reference Schwartz, Pick, Shazberg and Potasman2002).

Another particular genital manifestation of schistosomiasis had been addressed by Brandt et al. (Reference Brandt, Albuquerque, Brandt, Lorenzato, Leal, Barbosa and Nóbrega2003): severe hepatosplenic schistosomiasis may be associated with hypogonadism and, after porto-systemic collaterals have evolved or been surgically created, with varicocele. Specifically, hypogonadism and retarded sexual development as a manifestation of schistosomiasis which is not systematically explored (Brandt et al., Reference Brandt, Albuquerque, Brandt, Lorenzato, Leal, Barbosa and Nóbrega2003; Jatsa et el. Reference Jatsa, Femoe, Dongmo, Kamwa, Fesuh, Tchuem Tchuente and Kamtchouing2022).

The frequency of the diagnosis of genital schistosomiasis depends also on the diagnostic method. In autopsy digest methods are far more sensitive than histology for detecting schistosome ova (Edington et al., Reference Edington, Nwabuebo and Junaid1975). For detecting scrotal abnormalities scrotal ultrasonography has to be done. In screening programmes, a subject who does not think to have involvement of the scrotal organs is not likely to easily accept scrotal ultrasonography. Examination by transrectal ultrasonography is more sensitive for detecting prostatic lesions than transabdominal ultrasonography (Vilana et al., Reference Vilana, Corachan, Gascon, Valls and Bru1997; Al Saeed et al. Reference Al-Saeed, Sheikh, Kehinde and Makar2003). On the other hand, transrectal ultrasound is usually not applied in children, more time consuming than transabdominal ultrasound alone and is probably not that easily accepted in a field context where privacy is not that easily felt to be warranted.

Conclusions

  1. 1. Male genital schistosomiasis is a manifestation of schistosomiasis, which is neglected specially when occurring in children or adolescents.

  2. 2. Paediatricians and urologists should be aware of this condition to avoid stigmatization or unnecessary surgery.

  3. 3. Shame and fear of stigmatization may play a role of the particular neglect of this condition, also, because on the other hand, MGS in this age appears not to be particularly painful or threatening to the young patients.

  4. 4. Scrotal ultrasonography may require extensive and careful explanation to the patients and their parents if these methods are planned to be integrated into a screening programme.

  5. 5. Praziquantel treatment, when given before surgery appears to be efficient in most cases although, in some cases, surgery may be required.

  6. 6. The occurrence of MGS already in early childhood underscores the concept to treat schistosomiasis at an early age to prevent unnecessary complications which untreated may require surgery or may become no more reversible (Bustinduy et al., Reference Bustinduy, Stothard and Friedman2017).

Ethical approval

All procedures performed were approved by the data Protection Office and Ethics Committee of Charité-Universitätsmedizin Berlin and were in accordance with the ethical standards of the Helsinki Declaration and its later amendments. Approval for surveillance participation was provided by the UMRs’ legal representative, i.e. the Berlin Senate Department for Education, Youth and Science. Initial health inspection, tuberculosis screening and school entrance examination are performed at other facilities in Berlin. In the other cases informed consent for publication was obtained from the parents. Experimentation with vertebrates: Not applicable.

Author contributions

JR, CER and AKL cared for the patients. JR, SAK, JRS and HF conceived and designed the study. JR, SAK, CER and AKL conducted data gathering. JR, DF, RSS, HF, ALB, and JF drafted the article. RSS produced the graphical abstract. All authors contributed to writing the manuscript and approved the final version to be published.

Funding

This research received no specific grant from any funding agency, commercial or not-for-profit sectors.

Competing interests

The authors declare no conflicts of interest exist.

References

Abdel Wahab, MF, Shoeb, SM, Haseeb, NM, Sherif, M, El-deeb, T, El-fiky, A and El-beshlawy, OM (1981) Pathogenesis of hydrocaele in Egypt. J Egypt Soc Parasitol 11(2), 279–286.Google ScholarPubMed
Abul-Khair, ANM, Sobeih, AM, Taalab, M and Taalab, AAA (1980) Sonography of bilharzial masses of the scrotum. Journal of Clinical Ultrasound 8, 239–240.CrossRefGoogle ScholarPubMed
Adeyemi-Doro, FA, Osoba, AO and Junaid, TA (1979) Perigenital cutaneous schistosomiasis. British Journal of Venereal Diseases 55(6), 446–449.Google ScholarPubMed
Ahmed, F, Badheeb, M, Al Shami, E, Al Wageeh, S, Alyhari, Q, Al Yousofy, F and Ghabisha, S (2022) Testicular schistosomiasis presented as complicated epididymo-orchitis in a teenager. Journal of Pediatric Surgery Case Reports 84(2022), 102388.CrossRefGoogle Scholar
Al-Saeed, F, Figueiredo-Silva, J, Noroes, J, et al. (1994) Adult worms detected by ultrasonography in human bancroftian filariasis. The American Journal of Tropical Medicine and Hygiene 50, 753–757.Google Scholar
Al-Saeed, O, Sheikh, M, Kehinde, EO and Makar, R (2003) Seminal vesicle masses detected incidentally during transrectal sonographic examination of the prostate. Journal of Clinical Ultrasound 31(4), 201–206.CrossRefGoogle ScholarPubMed
Alves, W, Woods, RW and Gelfand, M (1955) The distribution of bilharzia ova in the male genital tract. The Central African Journal of Medicine 1(4), 166–167.Google ScholarPubMed
Amaral, F, Dreyer, G, Figueredo-Silva, J, Noroes, J, Cavalcanti, A, Samico, SC, Santos, A and Coutinho, A (1994) Live adult worms detected by ultrasonography in human Bancroftian filariasis. The American journal of tropical medicine and hygiene 50(6), 753–757.CrossRefGoogle ScholarPubMed
Aminu, MCD, Ibrahim, R, Nasiru, R and Isaac, P (2023) Male Genital Schistosomiasis in a twelve-year-old boy from Northeastern Nigeria: A case report. Journal of Epidemiological Society of Nigeria 6(1), 127–130.Google Scholar
Aribodor, OB, Azugo, NO, Jacob, EC, Ngenegbo, UC, Onwusulu, ND, Obika, I, Obikwelu, EM and Nebe, OJ (2024) Assessing urogenital schistosomiasis and female genital schistosomiasis (FGS) among adolescents in Anaocha, Anambra State, Nigeria: Implications for ongoing control efforts. BMC Public Health. 24(1), 952.CrossRefGoogle ScholarPubMed
Armbrust, ADF (1951) Genitourinary lesions in schistosomiasis mansoni. Trop Dis Bull 48(2), 168.Google Scholar
Badmus, TA, Takure, AO, Osasan, SA, Olajide, AO and Sabageh, DO (2012) Testicular schistosomiasis: A case report. Nigerian Postgraduate Medical Journal 19(1), 50–51.CrossRefGoogle ScholarPubMed
Bambirra, EA, de Souza Andrade, J, Bamberg, A, Costa, EA, Andrade, M and de Souza, AF (1986) Testicular schistosomiasis mansoni: A differential diagnostic problem with testicular neoplasias. probably adult The American Journal of Tropical Medicine and Hygiene 35,791–792.CrossRefGoogle ScholarPubMed
Barata, CH, Pinto-Silva, RA and Lambertucci, JR (1999) Abdominal ultrasound in acute schistosomiasis mansoni. The British Journal of Radiology 72(862), 949–952.CrossRefGoogle ScholarPubMed
Brandt, FT, Albuquerque, CD, Brandt, CT, Lorenzato, FR, Leal, CR, Barbosa, CD and Nóbrega, LV (2003) Varicoceles in adolescents and young adults after surgery for hepatosplenic schistosomiasis. Urologia Internationalis 71(4), 373–376.CrossRefGoogle Scholar
Bustinduy, AL, Randriansolo, B, Sturt, AS, Kayuni, SA, Leustcher, PDC, Webster, BL, Van Lieshout, L, Stothard, JR, Feldmeier, H and Gyapong, M (2022) An update on female and male genital schistosomiasis and a call to integrate efforts to escalate diagnosis, treatment and awareness in endemic and non-endemic settings: The time is now. Advances in Parasitology 115, 1–44.Google Scholar
Bustinduy, AL, Richter, J and King, C (2023) Schistosomiasis. Manson’s Tropical Medicine, 24th edn, chapter 58.Google Scholar
Bustinduy, AL, Stothard, JR and Friedman, JF (2017) Paediatric and maternal schistosomiasis: Shifting the paradigms. British Medical Bulletin 123(1), 115–125.CrossRefGoogle ScholarPubMed
Cassio Saito, D, de Barros, NM, Chammas, MC, Oliveira, IRS and Cerri, GG (2004) Ultrasound of tropical and infectious diseases that affect the scrotum. Ultrasound Quarterly 20(1), 12–18.CrossRefGoogle ScholarPubMed
Chaves, E and Figueiredo, JN (1965) Schistosomiasis of the scrotum. Revista Do Instituto de Medicina Tropical de São Paulo 7, 343–345.Google ScholarPubMed
Christinet, V, Lazdins-Helds, JK, Stothard, JR and Reinhard-Rupp, J (2016) Female genital schistosomiasis (FGS): From case reports to a call for concerted action against this neglected gynaecological disease. International Journal for Parasitology 46(7), 395–404.CrossRefGoogle Scholar
Chung, JJ, Kim, M-J, Lee, T, Voo, HS and Lee, JT (1997) Sonographic findings in tuberculous epididymitis and epidimo-orchitis. Journal of Clinical Ultrasound 25, 390–394.3.0.CO;2-5>CrossRefGoogle Scholar
Corachan, M, Escosa, R, Mas, J, Ruiz, L and Campo, E (1987) Clinical presentation of Schistosoma intercalatum infestation. Lancet i, 11391.Google Scholar
Corachan, M, Valls, ME, Gascon, J, Almeda, J and Vilana, R (1994) Hematospermia: A new etiology of clinical interest. The American Journal of Tropical Medicine and Hygiene 50(5), 580–584.CrossRefGoogle ScholarPubMed
Dauda, MM and Rafindadi, AH (2006) Testicular schistosomiasis simulating malignancy. Tropical Doctor 36(3), 182–183.CrossRefGoogle ScholarPubMed
De Souza Alves, LS, Assis, BP and Rezende, MM (2004) Schistosomal epididymitis. International Brazilian Journal of Urology 30(5), 413–415.CrossRefGoogle Scholar
Edington, GM, Nwabuebo, I and Junaid, TA (1975) The pathology of schistosomiasis in Ibadan, Nigeria with special reference to the appendix, brain, pancreas and genital organs. Transactions of the Royal Society of Tropical Medicine and Hygiene 69(1), 153–156.CrossRefGoogle Scholar
Ekenze, SO, Modekwe, VO, Nzegwu, MA and Ekpemo, SC (2015) Ezomike UO: Testicular Schistosomiasis Mimicking Malignancy in a Child: A Case Report. Journal of Tropical Pediatrics 61, 304–309.CrossRefGoogle Scholar
Eltayeb, AA (1969) Schistosomiasis of the epididymis. Journal of British Surgery 56(7), 552–553.CrossRefGoogle ScholarPubMed
Feldmeier, H, Richter, J, Helling-Giese, G and Krantz, I (1995) Reproductive tract infections and abortion among adolescent girls in rural Nigeria. Lancet 345(8953), 868–869.CrossRefGoogle ScholarPubMed
Fusco, D, Martínez-Pérez, GZ, Remkes, A, De Pascali, AM, Ortalli, M, Varani, S and Scagliarini, A (2022) A sex and gender perspective for neglected zoonotic diseases. Frontiers in Microbiology 13, 1031683.CrossRefGoogle ScholarPubMed
Gelfand, M and Davis, GB (1940) Bilharzial lesions of the testis. South African Medical Journal 14(17), 334–335.Google Scholar
Githae, GM (1992) Testicular schistosomiasis simulating a malignant tumour or tuberculosis. South African Medical Journal 81(6), 338.Google ScholarPubMed
Helling-Giese, G, Kjetland, EF, Gundersen, SG, Poggensee, G, Richter, J, Krantz, I and Feldmeier, H (1996a) Schistosomiasis in women: Manifestations in the upper reproductive tract. Acta Tropica 62(4), 225–238.CrossRefGoogle Scholar
Helling-Giese, G, Sjaastad, A, Poggensee, G, Kjetland, EF, Richter, J, Chitsulo, L, Kumwenda, N, Roald, B, Gundersen, SG, Krantz, I and Feldmeier, H (1996b) A synopsis of colposcopic and histopathological findings in women with schistosome lesions in the lower genital tract. Acta Tropica 62(4), 257–268.CrossRefGoogle Scholar
Ihekwaba, FN (1992) Schistosomiasis of the testis. Central African Journal of Medicine 38(3), 123–127.Google ScholarPubMed
Jatsa, HB, Femoe, UM, Dongmo, CN, Kamwa, RIN, Fesuh, BN, Tchuem Tchuente, LA and Kamtchouing, P (2022) Reduction of testosterone levels in Schistosoma haematobium- or Schistosoma mansoni-infected men: A cross-sectional study in two schistosomiasis-endemic areas of the Adamawa region of Cameroon. BMC Infectious Diseases 22(1), 230.CrossRefGoogle ScholarPubMed
Joshi, RA (1967) Total granulomatous infarction of testis due to Schistosoma haematobium. Journal of Clinical Pathology 20, 273–275.CrossRefGoogle ScholarPubMed
Jusot, JF, Simarro, PP and De Muynck, A (1997) La bilharziose à Schistosoma intercalatum: Considèrations cliniques et èpidèmiologiques [Schistosoma intercalatum bilharziasis: Clinical and epidemiological considerations]. Médecine Tropicale 57(3), 280–288.Google Scholar
Kayuni, SA, Cunningham, LJ, Kumwenda, D, Mainga, B, Lally, D, Chammudzi, P, Kapira, D, Namacha, G, Ntaba, B, Chisale, A, Nchembe, T, Kinley, L, Chibwana, E, Juhasz, A, Jones, S, Archer, J, Makaula, P, Chiphwanya, J, LaCourse, EJ, Musaya, J and Stothard, JR (2024) Challenges in the diagnosis and control of female genital schistosomiasis in sub-Saharan Africa: An exemplar case report associated with mixed and putative hybrid schistosome infection in Nsanje District, Southern Malawi. Frontiers Tropical Diseases 1–7, 1354119.Google Scholar
Kayuni, S, Lampião, F, Makaula, P, Juziwelo, L, Lacourse, EJ, Reinhard-Rupp, J, Leutscher, PDC and Stothard, JR and (2018) A systematic review with epidemiological update of male genital schistosomiasis (MGS): A call for integrated case management across the health system in sub-Saharan Africa. Parasite Epidemiology and Control 4, e00077. Erratum in: Parasite Epidemiol Control. 2020 Dec 24;11:e00196..Google Scholar
Kjetland, EF, Poggensee, G, Helling-Giese, G, Richter, J, Sjaastad, A, Chitsulo, L, Kumwenda, N, Gundersen, SG, Krantz, I and Feldmeier, H (1996) Female genital schistosomiasis due to S. haematobium: Clinical and parasitological findings in women in rural Malawi. Acta Tropica 62, 239–256.CrossRefGoogle Scholar
Kutz, JM, Rausche, P, Rasamoelina, T, Ratefiarisoa, S, Razafindrakoto, R, Klein, P, Jaeger, A, Rakotomalala, RS, Rakotomalala, Z, Randrianasolo, BS, McKay-Chopin, S, May, J, Rakotozandrindrainy, R, Puradiredja, DI, Sicuri, E, Hampl, M, Lorenz, E, Gheit, T, Rakotoarivelo, RA and Fusco, D (2023) Female genital schistosomiasis, human papilloma virus infection, and cervical cancer in rural Madagascar: A cross sectional study. Infectious Diseases of Poverty. 12(1), 89.CrossRefGoogle ScholarPubMed
Lee, KF, Hsueh, S and Tang, MH (2000) Schistosomiasis of the ovary with endometriosis and corpus hemorrhagicum: A case report. Chang Gung Med J 23(7), 438–441.Google ScholarPubMed
Leutscher, PD, Pedersen, M, Raharisolo, C, Jensen, JS, Hoffmann, S, Lisse, I, Ostrowski, SR, Reimert, CM, Mauclere, P and Ullum, H (2005) Increased Prevalence of Leukocytes and Elevated Cytokine Levels in Semen from Schistosoma haematobium–Infected Individuals. The Journal of Infectious Diseases 191(10), 1639–1647.CrossRefGoogle ScholarPubMed
Leutscher, P, Ramarokoto, CE, Reimert, C, Feldmeier, H, Esterre, P and Vennervald, BJ (2000) Community-based study of genital schistosomiasis in men from Madagascar. Lancet 355(9198), 117–118.CrossRefGoogle ScholarPubMed
Lopes, EJ, de Almeida, CE and Jacobino, M (2007a) Schistosomiasis mansoni in the seminal vesicle. Revista da Sociedade Brasileira de Medicina Tropical 40(3), 341–342.CrossRefGoogle Scholar
Lopes, RI, Leite, KR, Prando, D and Lopes, RN (2007b) Testicular schistosomiasis caused by Schistosoma mansoni: A case report from Brazil. Brazilian Journal of Infectious Diseases 11(5), 523–524.CrossRefGoogle Scholar
Lukács, T, Pajor, L, Hamza, L and El-seaghy, AA (1989) Schistosomal granulation masquerading as testicular tumour. Acta Chirurgica Hungarica 30(3), 187–191.Google ScholarPubMed
Madden, FC (1911) Two rare manifestations of bilharziosis. Lancet 178(4593), 754–755.CrossRefGoogle Scholar
Malik, MO and Ibrahim, A (1982) Scrotal swellings in Sudanese patients: A surgical pathology study. International Surgery 67(4 Suppl), 513–515.Google ScholarPubMed
McKenna, G, Schousboe, M and Paltridge, G (1997) Subjective change in ejaculate as symptom of infection with Schistosoma haematobium in travellers. BMJ 315(7114), 1000–1001.CrossRefGoogle ScholarPubMed
Mohammed, AZ, Edino, ST and Samaila, AA (2007) Surgical pathology of schistosomiasis. Journal of the National Medical Association 99(5), 570–574.Google ScholarPubMed
Monnet, P, Rosenberg, D, Mollard, P, Goddon, R and Morlat, C (1972) Bilharziose génito-urinaire de l’enfant [Urogenital bilharziasis in children]. Archives Francaises de Pediatrie 29(4), 441–442.Google Scholar
Msyamboza, K, Ngwira, B, Banda, R, Mkwanda, S and Brabin, B (2010) Sentinel surveillance of lymphatic filariasis, schistosomiasis soil transmitted helminths and malaria in rural southern Malawi. Malawi Medical Journal 22(1), 12–14.CrossRefGoogle ScholarPubMed
Neto, NM, Grande, JP and Moreira, HH (2004) Testicular schistosomiasis mimicking tumour. International Brazilian Journal of Urology 30(6), 502–503.CrossRefGoogle Scholar
Niamey Working Group, edited by Richter, J, Hatz, C, Campagne, G and Jenkins, J. Ultrasound in Schistoso¬miasis. A practical guide to the standardized use of ultrasonography for the assessment of schistosomiasis-re¬lated morbidity. WHO 2000; World Health Organization/TDR/STR/ SCH/WHO-Document: 1–41. www.who.int/tdr/publications/publications/ultrasound.htmGoogle Scholar
Oguntunde, OA, Ikhisemojie, S, Sonusi, SE, Oyebode, A, Abdulkareem, B and Banjo, AA (2020) Testicular schistosomiasis mimicking hydrocele in a child: A case report. Pan African Medical Journal 35, 56.CrossRefGoogle Scholar
Pawel, BR, Osman, J, Nance, ML and McGowan, KL (2008) Schistosomiasis, an unexpected finding in an inguinal hernia sac. Pediatric and Developmental Pathology 11(5), 402–404.CrossRefGoogle Scholar
Percheron, L, Leblanc, C, Ulinski, T, Fila, M, Malvy, D, Bacchetta, J, Guigonis, V, Debuisson, C, Launay, E, Martinez, E, Morand, A, Decramer, S, Schanstra, JP and Berry, A (2024) Pediatric urogenital schistosomiasis diagnosed in France. Pediatric Nephrology 39(6), 1893–1900.CrossRefGoogle ScholarPubMed
Picaud, A, Walter, P, Bennani, S, Minko Mi Etoua, D and Nlome Nze, AR (1990) Bilharziose tubaire à Schistosoma intercalatum révélée par un hémoperitoine [Fallopian tube bilharziasis caused by Schistosoma intercalatum disclosed by hemoperitoneum]. Archives d’Anatomie Et de Cytologie Pathologiques 38(5–6), 208–211.Google Scholar
Poggensee, G, Sikelu, M, Saría, M, Richter, J, Krantz, I and Feldmeier, H (1998) Schistosomiasis of the lower reproductive tract without egg excretion in urine. The American Journal of Tropical Medicine and Hygiene 59(9), 782–783.CrossRefGoogle ScholarPubMed
Ramarokoto, CE, Leutscher, PD, van Dam, G and Christensen, NO (2008) Ultrasonographical findings in the urogenital organs in women and men infected with Schistosoma haematobium in northern Madagascar. Transactions of the Royal Society of Tropical Medicine and Hygiene 102(8), 767–773.CrossRefGoogle Scholar
Rambau, PF, Chandika, A, Chalya, PL and Jackson, K (2011) Scrotal swelling and testicular atrophy due to schistosomiasis in a 9-year-old boy: A case report. Case Reports in Infectious Diseases 2011(1), 787961.CrossRefGoogle Scholar
Richter, J, Lux, J, Reinecke, P and Müller-Mattheis, V (2008) Of flukes and fistulae. The Lancet 371, 1308.CrossRefGoogle ScholarPubMed
Richter, J, Poggensee, G, Helling-Giese, G, Kjetland, E, Chitsulo, L, Koumenda, N, Gundersen, SG, Krantz, I and Feldmeier, H (1995) Transabdominal ultrasound for the diagnosis of Schistosoma haematobium infection of the upper female genital tract: A preliminary report. Transactions of the Royal Society of Tropical Medicine and Hygiene 89(5), 500–501.CrossRefGoogle ScholarPubMed
Richter, J, Poggensee, G, Kjetland, EF, Helling-Giese, G, Chitsulo, L, Kumwenda, N, Gundersen, SG, Deelder, AM, Reimert, CM, Haas, H, Krantz, I and Feldmeier, H (1996) Reversibility of lower reproductive tract abnormalities in women with Schistosoma haematobium infection after treatment with praziquantel. Acta Tropica 62, 309–311.CrossRefGoogle ScholarPubMed
Richter, J, Stegemann, U and Häussinger, D (2002) Hydrocele in a young boy with Schistosoma mansoni infection. British Journal of Urology International 89, 1–2.Google Scholar
Richter, J, Zwingenberger, K, Mohamed-Ali, Q, Moura Lima, W, Dacal, ARC, Vergetti Siqueira, G, Doehring-Schwerdtfeger, E and Feldmeier, H (1992) Hepatosplenic schistosomiasis: Comparison of sonographic findings in Brazilian and Sudanese Patients - correlation of sonographic findings with clinical symptoms. Radiology 184, 711–716.CrossRefGoogle ScholarPubMed
Ricosse, JH, Emeric, R and Courbil, LJ (1980) Aspects anatomo-pathologiques des bilharzioses (à propos de 286 pièces histopathologiques) [Anatomopathological aspects of schistosomiasis. A study of 286 pathological specimens. (author’s transl)]. Medecine Tsropicale(mARS) 40(1), 77–94.Google ScholarPubMed
Schanz, A, Richter, J, Beyer, I, Baldus, SE, Hess, AP and Kruessel, JSJ (2010) Genital schistosomiasis as a cause of female sterility and acute abdomen. Fertility & Sterility 93(6), 2075.e7–9.CrossRefGoogle ScholarPubMed
Schwartz, E, Pick, N, Shazberg, G and Potasman, I (2002) Hematospermia due to schistosome infection in travelers: Diagnostic and treatment challenges. Clinical Infectious Diseases 35(11), 1420–1424.CrossRefGoogle ScholarPubMed
Shanaube, K, Ndubani, R, Kelly, H, Webb, E, Mayaud, P, Lamberti, O, Fitzpatrick, J, Kasese, N, Sturt, A, Van Lieshout, L, Van Dam, G, Corstjens, PLAM, Kosloff, B, Bond, V, Hayes, R, Terris-Prestholt, F, Webster, B, Vwalika, B, Hansingo, I, Ayles, H and Bustinduy, AL (2024) Zipime-Weka-Schista study protocol: A longitudinal cohort study and economic evaluation of an integrated home-based approach for genital multipathogen screening in women, including female genital schistosomiasis, human papillomavirus, Trichomonas and HIV in Zambia. BMJ Open 14(6), e080395.CrossRefGoogle ScholarPubMed
Shekhar, KC, Soh, EB and Jayalakshmi, P (2000) Upper genital schistosomiasis mimicking an ovarian tumour. Medical Journal of Malaysia 55(3), 371–375.Google ScholarPubMed
Steinberger, RM, Lindsay, KG, Alassandri, R and Wise, GJ (1975) Infarction of testicle and Schistosoma mansoni. Urology 5(4), 567–569.CrossRefGoogle ScholarPubMed
Theuring, S, Friedrich-Jänicke, B, Pörtner, K, Trebesch, I, Durst, A, Dieckmann, S, Steiner, F, Harms, G and Mockenhaupt, FP (2016) Screening for infectious diseases among unaccompanied minor refugees in Berlin, 2014-2015. European Journal of Epidemiology 31(7), 707–710.CrossRefGoogle Scholar
van Delft, F, Visser, L, Polderman, A and van Lieshout, L (2007) Cough and alterations in semen after a tropical swim. The Netherlands Journal of Medicine 65(8), 304–306.Google ScholarPubMed
Vilana, R, Corachan, M, Gascon, J, Valls, E and Bru, C (1997) Schistosomiasis of the male genital tract: Transrectal sonographic findings. Journal of Urology 158, 1491–311.CrossRefGoogle ScholarPubMed
Walther, RR (1979) Chronic papular dermatitis of the scrotum due to Schistosoma mansoni. Archives of Dermatology 115(7), 869–870.CrossRefGoogle ScholarPubMed
Wedel, PG and Jess, P (1991) Testicular Schistosomiasis Simulating Malignancy. Case Report. Scandinavian Journal of Urology and Nephrology 25(3), 237–238.CrossRefGoogle ScholarPubMed
Weil, GJ, Lammie, PJ and Weiss, N (1997) The ICT Filariasis test. A rapid-format antigen test for diagnosis of bancroftian filariasis. Parasitology Today 13, 401–404.CrossRefGoogle Scholar
World Health Organization, 2020. Ending the neglect to attain the Sustainable Development Goals: A road map for neglected tropical diseases 2021–2030. https.//www.who.int/publications/i/item/9789240010352. Last accessed, September 1 , 2024.Google Scholar
Yu, Z, Wei, C, Wang, Y, Ye, Z, Wang, Z, Chen, Z, Ni, L, Yang, S, Gui, Y, Guan, Z, Cai, Z and Lai, Y (2013) Prostatic Schistosoma japonicum with atypical immunophenotyping of individual glandular tubes: A case report and review of the literature. The Southeast Asian J Trop Med Public Health 44(4), 568–573.Google ScholarPubMed
Ze Ondo, C, Sarr, A, Sow, Y, Thiam, I, Fall, B, Sow, D, Thiam, A, Diao, B, Fall, PA, Gaye, GW, Ndoye, AK and Ba, M (2014) Diagne BA Bilharziome testiculaire à Schistosomia haematobium: à propos de deux observations. Testicular bilharzioma by Schistosomia haematobium: About two cases. Progrès En Urologie 24(1), 67–69.CrossRefGoogle ScholarPubMed
Figure 0

Figure 1. Two-year-old German boy with Schistosoma mansoni infection, who had grown up in Kenya and Tanzania. Scrotal swelling and ultrasonography showing hydrocele before (1a, 1b) and six weeks after praziquantel (1c, 1d).

Figure 1

Figure 2. Scrotal ultrasonography of a 17-year-old Fulani refugee from Guinea Conakry with Schistosoma mansoni infection. Right testis immerged in anechoic scrotal fluid.

Figure 2

Figure 3. Hyperechoic spot in the prostate of a 12-year-old boy from Mali with S. haematobium infection.

Figure 3

Table 1. Reports on genital schistosomiasis in male children and adolescents