VAGINAL SCHISTOSOMIASIS IN AN AUSTRALIAN RETURNING FROM OVERSEAS TRAVEL PRESENTING TO A SEXUAL HEALTH-CENTER

We believe this to be the first reported case of vaginal schistosomias is due to Schistosoma haematobium in an Australian traveller returning from an endemic area. A 20-year-old woman presented to the sexual hea lth centre with vaginal lumps and an E coli urinary tract infection up on return from vacation in Western Europe and Africa. She had protecte d sexual contact with an American male while travelling in Western Eur ope. She was found to have granulomatous areas on the left lateral vag inal wall and the posterior fornix. A viral culture taken from the gra nulomatous areas was negative. Three vaginal biopsies contained numero us parasites and the findings were reported as typical of viable ova o f Schistosoma haematobium. Ova were also detected in the urine and sch istosoma antibodies were detected by enzyme immunoassay at a titre of 1.304 (high). At review the patient reported that she had swum in Lake Malawi but did not recall a skin itch. She was treated with praziquan tel 600 mg orally taken twice in one day. One month after treatment th e vagina was macroscopically normal and no schistosoma ova were found in urine specimens taken at 1, 3 and 4 months. This unusual presentati on of genital schistosomiasis to a sexual health centre highlights the importance of a careful travel history in returning overseas travelle rs.