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Schistosomiasis

Contents
  1. Read book excerpt
  2. Schistosomiasis: Introduction
  3. Schistosomiasis Misdiagnosis
  4. Schistosomiasis Complications
  5. Schistosomiasis Prevention
  6. Schistosomiasis Treatments
  7. Clinical trials
  8. Diagnosis of Schistosomiasis
  9. Schistosomiasis Overview
  10. More book excerpts for Schistosomiasis

Schistosomiasis: Excerpt from Professional Guide to Diseases (Eighth Edition)

Schistosomiasis, also known as bilharziasis, is a slowly progressive disease caused by blood flukes of the class Trematoda. There are three major types: Schistosoma mansoni and S. japonicum infect the intestinal tract; S. haematobium infects the urinary tract. (See Types of schistosomes.) The degree of infection determines the intensity of illness. Complications — such as portal hypertension, pulmonary hypertension, heart failure, ascites, hematemesis from ruptured esophageal varices, and renal failure — can be fatal.

Causes

The mode of transmission is bathing, swimming, wading, or working in water contaminated with Schistosoma larvae. These larvae penetrate the skin or mucous membranes and eventually work their way to the liver's venous portal circulation. There, they mature in 1 to 3 months. The adults then migrate to other parts of the body.

The female cercariae lay spiny eggs in blood vessels surrounding the large intestine or bladder. After penetrating the mucosa of these organs, the eggs are excreted in feces or urine. If the eggs hatch in fresh water, the first-stage larvae (miracidia) penetrate freshwater snails, which act as passive intermediate hosts. Cercariae produced in snails escape into water and begin a new life cycle.

Signs and symptoms

Initial signs and symptoms of schistosomiasis depend on the site of infection and the stage of the disease. Initially, a transient, pruritic rash develops at the site of cercariae penetration, along with fever, myalgia, and cough. (See Schistosomal dermatitis, page 276.) Later signs and symptoms may include hepatomegaly, splenomegaly, and lymphadenopathy. Worm migration and egg deposition may cause such complications as flaccid paralysis, seizures, and skin abscesses.

Diagnosis

CONFIRMING DIAGNOSIS Typical symptoms and a history of travel to endemic areas suggest the diagnosis; ova in the urine or stool or a mucosal lesion biopsy confirms it.

The white blood cell count shows eosinophilia.

Treatment

The treatment of choice is the anthelmintic drug praziquantel. Between 3 and 6 months after treatment, the patient will need to be examined again. If this checkup detects any living eggs, treatment may be resumed. With acute infection, corticosteroids may be ordered.

Special considerations

❑To help prevent schistosomiasis, teach people in endemic areas to work for a pure water supply and to avoid swimming or bathing in water that's known to be contaminated or potentially contaminated. If they must enter the water, tell them to wear protective clothing and to dry themselves afterward.

Pictures

Schistosomiasis - 1929.2.png
Schistosomiasis - 1929.1.png

Book Source Details

  • Book Title: Professional Guide to Diseases (Eighth Edition)
  • Author(s): Springhouse
  • Year of Publication: 2005
  • Copyright Details: Professional Guide to Diseases (Eighth Edition), Copyright © 2005 Lippincott Williams & Wilkins.

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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.



More About This Book:
Title: Professional Guide to Diseases (Eighth Edition)
Authors: Springhouse
Publisher: Lippincott Williams & Wilkins
Copyright: 2005
ISBN: 1-58255-370-X

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