Case Number : Case 2222 - 14 December 2018 Posted By: Dr. Richard Carr

I think these are ova of schistosomiasis.

Vulvar Schistosomiasis is my impression too.

It seems the ova have apical spines. Schistosoma haematobium is the likely species. 

I worked a lot of months in Victoria-Lake ( Mwanza-Tanzania ) at Bugando-Hospital. Schistosomiasis is endemic there. Urogenital system was the hottest, if memory serves...

Nice case! Never saw it in this location!

Yes this was another external quality assurance case. There was a history of foreign travel but I don't know anything else. There was a great majority for schistosomiasis with a few responders mentioning scabies, insect bite and amoebiasis.

I strongly suspect I picked it up myself at some stage as I swam and bathed in Lake Malawi several times. I was doing an autopsy study of cerebral malaria in Malawi (a study for which I would spend several weeks per year, during the rainy season, working in Blantyre). We travelled around a bit and Lake Malawi is a tropical paradise with sandy beaches and small fish that come and nibble gently at your feet! Too tempting not to swim! Funnily enough a much older and retired pathologist who worked in Warwick years before had a daughter living in Malawi had a prostate specimen sent to our lab a few years later and I reported the schisto in his specimen!