DOI: https://doi.org/10.36347/sjmcr.2026.v14i06.038

Pages: 1477-1481

Schistosomiasis remains a major parasitic disease worldwide and represents the second most prevalent parasitic infection after malaria, affecting more than 200 million people globally, with the highest burden in sub-Saharan Africa [1]. Urinary schistosomiasis, caused by Schistosoma haematobium, is widely distributed in Africa and has historically affected several North African countries, including Morocco [2,3]. Although Morocco has achieved significant progress toward interrupting transmission through national control programs, sporadic and imported cases continue to be reported, particularly in previously endemic regions [3]. Residual transmission foci and increasing population mobility may contribute to occasional new diagnoses [3]. Schistosoma haematobium infection primarily involves the urinary tract, where adult worms reside in the vesical and pelvic venous plexuses. Egg deposition within the bladder wall induces a chronic granulomatous inflammatory response, resulting in mucosal ulceration, fibrosis, calcifications, and, in advanced cases, obstructive uropathy [2,4]. Clinically, urinary schistosomiasis most frequently presents with terminal hematuria, dysuria, and irritative lower urinary tract symptoms [2]. In endemic or formerly endemic settings, bladder schistosomiasis should be considered in the differential diagnosis of hematuria and bladder mass lesions, as it may clinically and radiologically mimic urothelial carcinoma [4,5]. Early recognition is essential to prevent misdiagnosis and to ensure timely initiation of appropriate antiparasitic therapy. We report a case of vesical schistosomiasis diagnosed in Agadir, highlighting the diagnostic challenges and the importance of maintaining clinical suspicion even in regions where transmission has markedly declined.