Schistomiasis

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CLINICAL DESCRIPTIONSchistosomiasis is an infection with blood flukes of the genus Schistosoma. 

CLINICAL FEATURES

SIGNS AND SYMPTOMS

For S. haematobium & S. mansoni

• Swimmer’s itch: brief, localized urticaria/pruritus +/- eosinophilia
• Katayama fever: acute illness with fever, oesinophilila +/- pneumonitis
• CNS involvement (ectopic eggs or worms)
  • Meningoencephalitis
  • Seizures
• Pulmonary granulomas (or egg emboli)
  • Right ventricular failure/congestive cardiac failure

For Schistosoma haematobium

• Bladder granulomas:
  • Terminal haematuria
  • Obstructive uropathy (± secondary infection)
  • Hydroureter
  • Bladder calcification
  • Squamous bladder cancer
• Genital tract granulomas
  • Haemospermia
  • Inflammation in vulva/vagina/cervix
  • Infertility (Fallopian tube involvement)

For Schistosoma mansoni

• GI tract granulomas
  • colonic ulceration/bleeding; tenesmus
  • portal hypertension
  • hepatosplenomegaly
  • ‘pipestem fibrosis’ of liver
  • porto-caval shunting

TREATMENT

• Give Praziquantel 40 mg/kg as a single dose
• Children below 4 years of age Praziquantel 20mg/kg as stat dose

Note:  Assess all lesions around genitalia to check for genital schistosomiasis 

• Refer male and female genital schistosomiasis for laboratory diagnostics