# Pediatric epididymal schistosomiasis, challenging diagnosis, and implications

## TL;DR

This paper reports the first case of epididymal schistosomiasis in a U.S. pediatric patient, highlighting diagnostic challenges and the need for histology and thorough patient history.

## Contribution

The first documented case of pediatric epididymal schistosomiasis in the United States.

## Key findings

- Pediatric epididymal schistosomiasis is rare and requires histologic confirmation for diagnosis.
- A detailed patient history is crucial to identify potential exposure to endemic regions.
- Follow-up data on systemic sequelae in such cases remains limited.

## Abstract

Schistosomiasis is a parasitic infection that may be difficult to diagnose in non-endemic regions and may manifest with epididymal involvement.

Testicular schistosomiasis remains a rare disease. The diagnosis is based on clinical suspicion due to a low degree of specificity when it comes to laboratory tests and imaging studies. Treatment mainstays are anthelminthic medication and excision.

We present the first report of epididymal schistosomiasis in a pediatric patient in the United States. Patients require a definitive histologic diagnosis. It is helpful to obtain a thorough history to elucidate exposure to endemic areas as part of assessment and treatment.

•Schistosomiasis (SM) is rare parasitic infection that can present rarely as a pseudotumor of the testes or epididymis.•Histology is needed for diagnosis.•Organ sparing surgery may be considered if no involvement is clinically suspected.•There is scarce information regarding follow-up for systemic sequelae in these cases.

Schistosomiasis (SM) is rare parasitic infection that can present rarely as a pseudotumor of the testes or epididymis.

Histology is needed for diagnosis.

Organ sparing surgery may be considered if no involvement is clinically suspected.

There is scarce information regarding follow-up for systemic sequelae in these cases.