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The following text is from an archived Red Book® edition and may not reflect current recommendations or information. To view the current edition, click here.
Section 3. Summaries of Infectious Diseases
Schistosomiasis
Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
CLINICAL MANIFESTATIONS: Initial entry of the infecting larvae (cercariae) through the skin commonly is accompanied by a transient, pruritic, papular rash (cercarial dermatitis). After penetration, the organism enters the bloodstream and migrates through the lungs. Each of the 3 major human schistosome parasites lives in some part of the venous plexus that drains the intestines or the bladder. Four to 8 weeks after exposure to Schistosoma mansoni or Schistosoma japonicum, an acute illness that manifests as fever, malaise, cough, rash, abdominal pain, diarrhea, nausea, lymphadenopathy, and eosinophilia (Katayama fever) can develop. Heavy infestation can result in mucoid bloody diarrhea accompanied by tender hepatomegaly. The severity of symptoms associated with chronic disease is related to the worm burden. People with low to moderate worm burdens can be asymptomatic; heavily infected people can have a range of symptoms caused primarily by inflammation and fibrosis triggered by eggs produced by adult worms. Portal hypertension can develop and cause hepatosplenomegaly, ascites, and esophageal varices. Long-term involvement of the colon produces abdominal pain and bloody diarrhea. In Schistosoma haematobium infections, the bladder becomes inflamed and fibrotic. Symptoms and signs include dysuria, urgency, terminal microscopic and gross hematuria, secondary urinary tract infections, and nonspecific pelvic pain. Other organ systems can be involved from embolized eggs, for example, to the lungs, causing pulmonary hypertension; or to the central nervous system, notably the spinal cord in S mansoni or S haematobium infections and the brain in S japonicum infection.
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Swimmer’s itch (cercarial dermatitis or schistosome dermatitis) is caused by the larvae of other avian and mammalian schistosome species that penetrate human skin but do not complete the life cycle
Related text in Red Book:
- Drugs for Parasitic Infections
Red Book 2003: 744-770.[Extract] [Full Version]
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