European Journal of Obstetrics & Gynecology and Reproductive Biology 79 (1998) 213–216 Case report Schistosomiasis haematobium as a cause of vulvar hypertrophy a b, c d * Joop S.E. Laven , Michel P.H. Vleugels , Anthonius S.M. Dofferhoff , Peter Bloembergen a Department of Obstetrics and Gynaecology, University Hospital St Radboud, Nijmegen, The Netherlands b Department of Obstetrics and Gynaecology, Canisius Wilhelmina Hospital, Weg door Jonkerbos 100, 6500 GS Nijmegen, The Netherlands c Department of Internal Medicine, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands d Department of Microbiology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands Received 10 March 1997; received in revised form 29 October 1997; accepted 26 January 1998 Abstract Schistosomiasis is the most frequently imported helminthic infection in The Netherlands. Patients with Schistosoma haematobium infections usually present with fever, hematuria, dysuria, or urinary frequency. The ectopic localizations in female genital schistosomiasis are frequently misdiagnosed or confounded with sexually transmitted diseases or genital tract cancers. This paper describes a patient who presented with vulvar hypertrophy as a symptom of acute female genital schistosomiasis. The aim of this paper is to draw attention to a neglected parasitic disease that in the future will be encountered in increasing numbers in Western Europe.  1998 Elsevier Science Ireland Ltd Keywords: Female genital schistosomiasis; Tourism 1. Introduction patient [4]. In this paper we describe a patient who presented with vulvar hypertrophy as the only symptom of Schistosomiasis (bilharziasis) is the most frequently acute schistosomiasis. imported helminthic infection in The Netherlands, in either The aim of this paper is to draw attention to this Dutch tourists infected during travels to tropical countries parasitic disease that in the future will be encountered in or in a large group of immigrants from Suriname [1]. increasing numbers in Western Europe. Acute schistosomiasis in tourists returning from endemic areas usually presents with fever, flu-like symptoms, diarrhea, or hematuria [2]. Patients with Schistosoma 2. Case report haematobium infections ( S. haematobium) usually present with fever, hematuria, dysuria, or urinary frequency, A 33-year-old Dutch woman came to the gynecological whereas abdominal pain, diarrhea, or rectal bleeding are outpatient department complaining of a progressive swell- associated with Schistosoma mansoni [2,3]. The so-called ing of her left labium minus. Furthermore, she had noted a ectopic localizations in female genital schistosomiasis painless inguinal lymphoma on the same side. The unila- (FGS) are frequently misdiagnosed or confounded with teral vulvar swelling had started 7 weeks before and was sexually transmitted diseases (STD) or genital tract cancers not accompanied by soreness, itching, ulceration or discol- by experienced gynecologists as well as by the afflicted oration of the affected site. The patient had not ex- perienced any recent period of illness or fever. She did, however, report recent periods of dysuria, frequency and * discolored urine. Weight loss was not reported. She recent- Corresponding author. Tel.: 131 24 3658750; fax: 131 24 3658752; e-mail: 100722.664@compuserve.com ly visited Malawi and had swum in Lake Malawi several 0301-2115 / 98 / $19.00  1998 Elsevier Science Ireland Ltd All rights reserved. PII: S0301-2115(98)00033-5