title: Confocal laser scanning microscopy, a new in vivo diagnostic tool for schistosomiasis.
abstract: BACKGROUND
  The gold standard for the diagnosis of schistosomiasis is the detection of the parasite's characteristic eggs in urine, stool, or rectal and bladder biopsy specimens. Direct detection of eggs is difficult and not always possible in patients with low egg-shedding rates. Confocal laser scanning microscopy (CLSM) permits non-invasive cell imaging in vivo and is an established way of obtaining high-resolution images and 3-dimensional reconstructions. Recently, CLSM was shown to be a suitable method to visualize Schistosoma mansoni eggs within the mucosa of dissected mouse gut. In this case, we evaluated the suitability of CLSM to detect eggs of Schistosoma haematobium in a patient with urinary schistosomiasis and low egg-shedding rates.
  
  
  RESULTS
  The confocal laser scanning microscope used in this study was based on a scanning laser system for imaging the retina of a living eye, the Heidelberg Retina Tomograph II, in combination with a lens system (image modality). Standard light cystoscopy was performed using a rigid cystoscope under general anaesthesia. The CLSM endoscope was then passed through the working channel of the rigid cystoscope. The mucosal tissue of the bladder was scanned using CLSM. Schistoma haematobium eggs appeared as bright structures, with the characteristic egg shape and typical terminal spine.
  
  
  CONCLUSIONS
  We were able to detect schistosomal eggs in the urothelium of a patient with urinary schistosomiasis. Thus, CLSM may be a suitable tool for the diagnosis of schistosomiasis in humans, especially in cases where standard diagnostic tools are not suitable.
authors.affiliation: Division of Tropical Medicine and Infectious Diseases, Department of Internal Medicine, University of Rostock, Rostock, Germany. carlos.fritzsche@med.uni-rostock.de
authors.forename: Carlos
authors.initials: C
authors.lastname: Fritzsche
authors.forename: Oliver
authors.initials: O
authors.lastname: Stachs
authors.forename: Martha Charlotte
authors.initials: MC
authors.lastname: Holtfreter
authors.forename: Constanze
authors.initials: C
authors.lastname: Nohr-Łuczak
authors.forename: Rudolf Friedrich
authors.initials: RF
authors.lastname: Guthoff
authors.forename: Emil Christian
authors.initials: EC
authors.lastname: Reisinger
mesh_terms: D006801:Humans; D008297:Male; D018613:Microscopy, Confocal / Q000379:methods*; D008875:Middle Aged; D012553:Schistosomiasis haematobia / Q000175:diagnosis*; D001743:Urinary Bladder / Q000469:parasitology; D019459:Urothelium / Q000469:parasitology