Difference between revisions of "Schistosomiasis"

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(Clinical Features)
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**Second most common cause of esophageal varicies worldwide
 
**Second most common cause of esophageal varicies worldwide
 
**Greatly elevated bladder cancer rates in endemic areas
 
**Greatly elevated bladder cancer rates in endemic areas
**Can cause renal failure, liver failure, pulmonary hyptertension, GI bleeds and rarely CNS symptoms
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**Can cause renal failure, liver failure, [[pulmonary hypertension]], [[GI bleed]]s and rarely CNS symptoms
 
***Mostly through fibrosis of affected organs
 
***Mostly through fibrosis of affected organs
 
**Genitourinary schistosomiasis
 
**Genitourinary schistosomiasis
 
***Caused by sores in the genital tract
 
***Caused by sores in the genital tract
 
***May persist even after treatment
 
***May persist even after treatment
***Greatly increases risk of HIV infection
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***Greatly increases risk of [[HIV]] infection
  
 
*Acute presentations
 
*Acute presentations

Revision as of 00:03, 13 July 2016

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

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

Differential Diagnosis

Diagnosis

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 Cx
    • Consider US for hepatosplenic (periportal fibrosis) or urinary disease (hydro)
    • Echo and CXR for pulmonary HTN and/or cor pulmonale
    • Consider CT or MRI for CNS disease or further w/u of periportal fibrosis

Evaluation

Management

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

Disposition

See Also

External Links

References