Diagnostic value of a miracidium in urinary sediment

Although rarely encountered in the United States, urinary tract schistosomi asis occurs commonly in many countries in the eastern hemisphere. Travel an d immigration may contribute to imported cases of schistosomiasis. Excessiv e morbidity and increased mortality, including the development of urinary-t ract squamous-cell carcinoma, are associated with untreated Schistosoma hae matobium infection. Therefore, in the appropriate clinical context, all eff orts should be made to rule out infectious and readily treatable causes of chronic hematuria. The presence of characteristic eggs in the urinary sediment is the usual me ans of diagnosing a S. haematobium infection. Additionally the small and le ss commonly encountered miracidium stage of S. haematobium may also be pres ent in the urine, which is another means of diagnosing urinary tract schist osomiasis. The present report describes a case in which a miracidium was de tected in a fresh, unstained urine specimen. As detection of miracidia can be made in specimens also processed by routine cytologic methods, it behoov es cytologists to be aware of this entity for the diagnosis of schistosomia sis. (C) 1999 Wiley-Liss, Inc.