Schistosomiasis (Bilharziasis)

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Schistosomiasis is a water borne parasitic infection caused by several species of trematode worms. 

Causes

• The urinary form is caused by Schistosoma haematobium whilst the intestinal form is caused mainly by Schistosoma mansoni

Signs and symptoms

Acute

• Headache
• Dysuria
• Haematuria
• Cystitis
• Malaise
• Bloody diarrhoea
• Cough
• Right upper quadrant (RUQ) pain

Chronic

• Bloody diarrhoea
• Abdominal pain, cramping, RUQ pain
• Haematemesis (with portal hypertension)
• Ascites (with portal hypertension)
• Haematuria
• Dysuria
• Valvular or perianal lesions
• Dyspnoea on exertion (with pulmonary hypertension)
• Fatigue (with pulmonary hypertension)

Investigations

• Proper diagnosis can only be made by microscopy

Pharmacological treatment

Praziquantel, oral

Adult:

20mg/kg initially, then another dose of 20mg/kg after 4-6 hours

Child:

4-17 years: 20mg/kg 3 times daily for one day

Doses should be given 4-6 hours apart.