Difference between revisions of "Schistosomiasis"

(See Also)
Line 7: Line 7:
  
 
==Clinical Features==
 
==Clinical Features==
*Mostly a chronic condition
+
===Acute===
**Second most common cause of esophageal varicies worldwide
+
*Cutaneous rash/itching from cercariae penetration (immediate)
**Greatly elevated bladder cancer rates in endemic areas
+
*Katayama fever-Fever, [[abdominal pain]], Fatigue, Cough, [[Diarrhea]], Eosinophilia (lasts 4-8 weeks)
**Can cause renal failure, liver failure, [[pulmonary hypertension]], [[GI bleed]]s and rarely CNS symptoms
 
***Mostly through fibrosis of affected organs
 
**Genitourinary schistosomiasis
 
***Caused by sores in the genital tract
 
***May persist even after treatment
 
***Greatly increases risk of [[HIV]] infection
 
  
*Acute presentations
+
===Chronic (mostly a chronic condition)===
**Cutaneous rash/itching from cercariae penetration (immediate)
+
*Second most common cause of esophageal varicies worldwide
**Katayama fever-Fever, Abdominal pain, Fatigue, Cough, Diarrhea, Eosinophilia (lasts 4-8 weeks)
+
*Greatly elevated bladder cancer rates in endemic areas
 +
*Can cause renal failure, liver failure, [[pulmonary hypertension]], [[GI bleed]]s and rarely CNS symptoms
 +
**Mostly through fibrosis of affected organs
 +
*Genitourinary schistosomiasis
 +
**Caused by sores in the genital tract
 +
**May persist even after treatment
 +
**Greatly increases risk of [[HIV]] infection
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==

Revision as of 13:14, 8 December 2017

Background

  • Caused by parasitic trematodes of the species Schistosoma
  • Reservoir is freshwater snails
  • Endemic in areas of Africa and Southern Asia
  • The Cercariae (the stage of trematode released by the snail) can infect by direct penetration through the skin
  • Infects >200million people worldwide with 10% suffering severe consequences

Clinical Features

Acute

  • Cutaneous rash/itching from cercariae penetration (immediate)
  • Katayama fever-Fever, abdominal pain, Fatigue, Cough, Diarrhea, Eosinophilia (lasts 4-8 weeks)

Chronic (mostly a chronic condition)

  • Second most common cause of esophageal varicies worldwide
  • Greatly elevated bladder cancer rates in endemic areas
  • Can cause renal failure, liver failure, pulmonary hypertension, GI bleeds and rarely CNS symptoms
    • Mostly through fibrosis of affected organs
  • Genitourinary schistosomiasis
    • Caused by sores in the genital tract
    • May persist even after treatment
    • Greatly increases risk of HIV infection

Differential Diagnosis

Evaluation

Work-up

  • ELISA
  • PCR from stool or urine
  • Stool and Urine for ova/parasites
    • biopsy may be needed for those who do not show ova/parasites in stool/urine
  • CBC, Alk Phos, GGT, ALT/AST, Cr, Blood cultures
  • Consider ultrasound for hepatosplenic (periportal fibrosis) or urinary disease (hydro)
  • Echo and CXR for pulmonary hypertension and/or cor pulmonale
  • Consider CT or MRI for CNS disease or further workup of periportal fibrosis

Management

  • Praziquantel 20mg/kg PO for two doses in 1 day [1]
    • S.japnonicum requires 3 doses in 1 day

Disposition

  • Generally may be discharged
  • Admit if concern for CNS infection

See Also

External Links

References