Genital Schistosomiasis - Mucosal Findings

Mucosal Findings

Mucosal grainy, sandy patches seem to be pathognomonic for S. haematobium infection in the female genitals. S. haematobium infection probably also causes mucosal bleeding and inflammation. Grainy, sandy patches are significantly associated with S. haematobium ova only (OR 4.89, 95%CI 2.14-11.17, p<0.001). Genital S. haematobium ova are also significantly associated with homogenous yellow sandy patches in the genital mucosa (OR 2.94, 95%CI 1.35-6.44, p=0.007), mucosal bleeding (OR 8.13, 95%CI 2.01-32.9, p=0.003) and abnormal blood vessels (OR 5.16, 95%CI 2.04-13.07, p=0.001). The three latter phenomena are, however, also associated with other reproductive-tract diseases. Ova presence is not a predictor for ulcers, papillomata, leukoplakia, polyps or cell atypia. The findings are the same in all adult age groups—indicating that genital lesions do not undergo a change with age, or that women by the age of 20 have already passed into a chronic state of infection. The full clinical significance of genital schistosomiasis has yet to be established. The concomitant blood-vessel friability and inflammation may give weight to circumstantial evidence for bidirectional transmission of HIV.