Macroscopic hematuria: A rare etiology in western countries

Although schistosomiasis is one of the most prevalent parasitic diseases worldwide, the infection frequently being found in migrants and travelers, its recognition in Italy may be delayed as patients may either present symptoms or be asymptomatic, especially with regard to localization in the bladder, in a similar way to other infectious diseases. We report a case of urinary schistosomiasis in a young African male with persistent hematuria which did not respond to antibiotic treatment administered on suspicion of a urinary bacterial infection. The present case indicates that urinary schistosomiasis should be ruled out, especially in those patients presenting symptoms and coming from areas known to be endemic for helminthiasis. Finally, bladder polyps must be ruled out in cases of migrants with unexplained urinary inflammation associated either with or without hematuria.