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Correspondence: Schistosoma Haematobium In Cervical Smear

The various parasites observed in cervicovaginal smears are Trichomonas vaginalis, Enterobius vermicularis, Trichuris trichura, Entamoeba histolytica, Entamoeba gingivalis, Wuchereria bancrofti, Ascaris lumbricoides, Hymenolepis nana, Toxoplasma and Schistosoma'. Although three comprehensive articles were published by Berry on gynaecologic bilharziasis in cytologic material between the mid 1960s and mid 197Osz4, there have been no further reports in English literature to the best of our knowledge. Here we report a case of Schistosoma haematobium infection of the cervix diagnosed initially from cytologic examination. We received the cervical smear of a 30-year-old Egyptian lady living in Kuwait for the last 16 years. She presented with a history of vaginal discharge and contact bleeding. She was married and had four children. Gynaecological examination showed a cervical erosion. Cervical smears collected on two occasions within 10 days revealed many embryonated eggs of S. haematobium with characteristic terminal spines and an inflammatory exudate rich in eosinophils (Figure 1). Some of the eggs showed degenerative changes in the form of refractile cell walls, and there was also evidence of calcification around the eggs (Figure 2). A fragment of cervical epithelium with an egg lying in the superficial part and the end with the terminal spine protruding out of the epithelium, was observed in the first smear (Figure 3). Following the cytodiagnosis of cervical schistosomiasis, a cone biopsy was performed which corroborated the cytodiagnosis.