Schistosomiasis: Difference between revisions
ClaireLewis (talk | contribs) |
ClaireLewis (talk | contribs) |
||
Line 36: | Line 36: | ||
**Consider US for hepatosplenic (periportal fibrosis) or urinary disease (hydro) | **Consider US for hepatosplenic (periportal fibrosis) or urinary disease (hydro) | ||
**Echo and CXR for pulmonary HTN and/or cor pulmonale | **Echo and CXR for pulmonary HTN and/or cor pulmonale | ||
**Consider CT or MRI for CNS disease or further | **Consider CT or MRI for CNS disease or further workup of periportal fibrosis | ||
===Evaluation=== | ===Evaluation=== |
Revision as of 05:32, 14 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
- UTI
- STD
- Intestional parasites
- Traveler's diarrhea
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 workup 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
- ↑ CDC. Schistosomiasis. http://www.cdc.gov/parasites/schistosomiasis/health_professionals/index.html