P188 Do genitourinary medicine physicians need to know about tropical diseases?

Background Many individuals presenting to genitourinary medicine (GUM) clinics have travelled or may have been born outside the UK. A number of tropical infections can present with genitourinary symptoms. Aims To investigate how many cases of schistosomiasis were diagnosed in a GUM clinic over a 3-year period, whether they were treated according to the European Association of Urology guidelines for the management of urogenital schistosomiasis and whether treatment led to symptomatic improvement. Methods All the schistosoma serology requests from our clinic in 2009–2011 were obtained and identified as positive, negative or equivocal results. The results were separated into those from our HIV clinic and those from GUM. The notes for all the positive and equivocal results were reviewed. Results 182 tests were performed on 168 different individuals. 151 tests (83.0%) were carried out in HIV clinic, 31 tests (17.0%) in GUM. 4 (2.6%) of the tests carried out in HIV clinic were positive. 4 (12.9%) of tests carried out in GUM were positive. All positive results were non-British born males ranging in age from 28 to 42. All individuals with positive results had symptoms or signs that could have been attributed to urogenital schistosomiasis. Five of the 8 individuals had urine and stool sent to look for schistosome eggs, two had just urine analysed and 1 had neither. 6 individuals were referred to Infectious Diseases, two were managed in GUM. Seven of the 8 individuals were treated with praziquantel according to the guidelines. One individual declined treatment. Of those individuals treated, two had full resolution of signs and symptoms, three had partial resolution, one was followed-up in another department and one had no resolution of symptoms. Discussion Genitourinary medicine physicians should consider a diagnosis of schistosomiasis in at-risk individuals when standard tests have not provided a diagnosis and resolution of symptoms.