Schistosomiasis
BY
Amira Al Balakosy
Assistant Professor of Tropical Medicine
Extended Modular Program
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Schistosomiasis
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Clinical picture
Cercarial Dermatitis: which can progress to a pruritic maculopapular rash
that persists for some days.
Acute schistosomiasis (Katayama syndrome):A febrile illness may develop
2-8 weeks after exposure in persons without prior infection, most
commonly after heavy infection with S mansoni. Presenting symptoms
and signs include acute onset of fever; headache; myalgias; cough;
malaise; urticaria; diarrhea, which may be bloody; hepatosplenomegaly;
lymphadenopathy; and pulmonary infiltrates. Acute schistosomiasis
usually resolves in 2-8 weeks.
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Chronic Schistosomiasis:
• Asymptomatic, but an estimated 50-60% have symptoms and 5 - 10 %
have advanced organ damage.
• Asymptomatic infected children may suffer from anemia and growth
retardation.
• Intestinal schistosomiasis: abdominal pain, fatigue, diarrhea, and
hepatomegaly. Over years, anorexia, weight loss, weakness, colonic
polyps, and features of portal hypertension develop. Late
manifestations include hematemesis from esophageal varices, hepatic
failure, and pulmonary hypertension.
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may present within months of
Urinary schistosomiasis:
infection with hematuria and dysuria, most
commonly in children and young adults. Fibrotic
changes in the urinary tract can lead to:
hydroureter, hydronephrosis, bacterial urinary
infections and, ultimately, kidney disease or
bladder cancer.
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Hepatic Schistosomiasis
Repeated embolization of ova to the liver leading to
periportal fibrosis and portal hypertension.
Stages:
1. Hepatomegaly
2. HSM
3. Huge splenomegaly
4. Ascitic stage
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Affection of other systems in
schistosomasis
CVS: cor pulmonale
CNS: encephalopathy
Kidney: glomerulopathy
Hypersplenism
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Diagnosis
Stool or urine analysis: egg (closed infection)
Biopsy: egg and granuloma
Serology: can’t differentiate acute from past
infection.
Serology is of limited use in endemic settings,
but can be helpful in travelers from nonendemic
regions.
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Treatment
Praziquantel: The drug is administered for 1 day
at an oral dose of 40 mg/kg (in one or two
doses) - Praziquantel can be used in pregnant
and lactating women
TTT of complications.
Mass treatment
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