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Early Detection of Schistosoma Egg–Induced Pulmonary Granulomas in a Returning Traveler

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  • Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Institut de Biologie en Santé, Angers, France; Groupe d'Etude des Interactions Hôte-Pathogène, L'UNAM Université, Université d'Angers, Angers, France; Laboratoire d'Anatomo-Cytopathologie, Centre de Pathologie de l'Ouest, Angers, France; Maison Médicale des Spécialistes, Village Santé Angers Loire, Trélazé, France

We report the case of a French traveler who developed acute pulmonary schistosomiasis 2 months after visiting Benin. He presented with a 1-month history of fever, cough, and thoracic pain. Initial investigations revealed hypereosinophilia and multiple nodular lesions on chest computed tomography scan. Lung biopsies were performed 2 months later because of migrating chest infiltrates and increasing eosinophilia. Histological examination showed schistosomal egg–induced pulmonary granulomas with ova exhibiting a prominent terminal spine, resembling Schistosoma haematobium. However, egg shells were Ziehl–Neelsen positive, raising the possibility of a Schistosoma intercalatum or a Schistosoma guineensis infection. Moreover, involvement of highly infectious hybrid species cannot be excluded considering the atypical early pulmonary oviposition. This case is remarkable because of the rarity of pulmonary schistosomiasis, its peculiar clinical presentation and difficulties in making species identification. It also emphasizes the need to consider schistosomiasis diagnosis in all potentially exposed travelers with compatible symptoms.

Author Notes

* Address correspondence to Yohann Le Govic, Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Institut de Biologie en Santé, 4 rue Larrey, 49933 Angers Cedex 9, France. E-mail: yohann.legovic@chu-angers.fr† These authors contributed equally to this work.

Conflict of interest: Because this work did not include any primary research, no ethics committee approval was sought.

Authors' addresses: Noémie Coron and Ludovic de Gentile, Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Institut de Biologie en Santé, Angers, France, E-mails: coron.noemie@gmail.com and ludegentile@chu-angers.fr. Yohann Le Govic, Marc Pihet, and Dominique Chabasse, Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Institut de Biologie en Santé, Angers, France, and Groupe d'Etude des Interactions Hôte-Pathogène, L'UNAM Université, Université d'Angers, Angers, France, E-mails: yohann.legovic@chu-angers.fr, mapihet@chu-angers.fr, and dochabasse@chu-angers.fr. Sami Kettani, Laboratoire d'Anatomo-Cytopathologie, Centre de Pathologie de l'Ouest, Angers, France, E-mail: kettani.sami@gmail.com. Sandrine Hemery, Maison Médicale des Spécialistes, Village Santé Angers Loire, Trélazé, France, E-mail: sandrine.beneteau@gmail.com.

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