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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 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, hepatosplenomegaly,
diarrhea, nausea, lymphadenopathy, and eosinophilia (Katayama
fever) can develop. Heavy infection 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 may never develop
overt clinical illness; people with significant worm burdens
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 and hematemesis. Long-term involvement
of the colon produces abdominal pain and bloody diarrhea. In
Schistosoma haematobium infections, the bladder can become inflamed
and fibrotic. Symptoms and signs include dysuria, urgency, terminal
microscopic and gross hematuria, secondary urinary tract infections,
and nonspecific pelvic pain. An association between
S haematobium and bladder cancer has been reported. 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.
Swimmer’s itch (cercarial dermatitis or schistosome dermatitis) is caused by the larvae of other avian and mammalian schistosome species . . . [Go to Full Text]
Related text in Red Book:
- Drugs for Parasitic Infections
Red Book
2006: 790-820.
[Extract]
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