Schistosomiasis: Difference between revisions
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=Background= | ==Background== | ||
*Caused by parasitic trematodes of the species Schistosoma | *Caused by parasitic trematodes of the species Schistosoma | ||
*Reservoir is freshwater snails | *Reservoir is freshwater snails | ||
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*Infects >200million people worldwide with 10% suffering severe consequences | *Infects >200million people worldwide with 10% suffering severe consequences | ||
= | ==Clinical Features== | ||
= | |||
*Mostly a chronic condition | *Mostly a chronic condition | ||
**Second most common cause of esophageal varicies worldwide | **Second most common cause of esophageal varicies worldwide | ||
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**Katayama fever-Fever, Abdominal pain, Fatigue, Cough, Diarrhea, Eosinophilia (lasts 4-8 weeks) | **Katayama fever-Fever, Abdominal pain, Fatigue, Cough, Diarrhea, Eosinophilia (lasts 4-8 weeks) | ||
*Diagnosis | ==Differential Diagnosis== | ||
*[[UTI]] | |||
*[[STD]] | |||
*Intestional parasites | |||
*[[Traveler's diarrhea]] | |||
==Diagnosis== | |||
===Work-up=== | |||
**ELISA | **ELISA | ||
**PCR from stool or urine | **PCR from stool or urine | ||
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**Consider CT or MRI for CNS disease or further w/u of periportal fibrosis | **Consider CT or MRI for CNS disease or further w/u of periportal fibrosis | ||
= | ===Evaluation=== | ||
==Management== | |||
*Praziquantel 20mg/kg PO for two doses in 1 day | *Praziquantel 20mg/kg PO for two doses in 1 day | ||
**S.japnonicum requires 3 doses in 1 day | **S.japnonicum requires 3 doses in 1 day | ||
= | ==Disposition== | ||
==See Also== | |||
==External Links== | |||
==References== | |||
<references/> | |||
[[Category:ID]] | [[Category:ID]] | ||
[[Category:TropMed]] | [[Category:TropMed]] | ||
Revision as of 20:26, 4 September 2015
Background
- Caused by parasitic trematodes of the species Schistosoma
- Reservoir is freshwater snails
- Endemic in areas of Africa and Southern Asia
- The Cercariae (the stage of trematode released by the snail) can infect by direct penetration through the skin
- Infects >200million people worldwide with 10% suffering severe consequences
Clinical Features
- Mostly a chronic condition
- Second most common cause of esophageal varicies worldwide
- Greatly elevated bladder cancer rates in endemic areas
- Can cause renal failure, liver failure, pulmonary hyptertension, GI bleeds and rarely CNS symptoms
- Mostly through fibrosis of affected organs
- Genitourinary schistosomiasis
- Caused by sores in the genital tract
- May persist even after treatment
- Greatly increases risk of HIV infection
- Acute presentations
- Cutaneous rash/itching from cercariae penetration (immediate)
- Katayama fever-Fever, Abdominal pain, Fatigue, Cough, Diarrhea, Eosinophilia (lasts 4-8 weeks)
Differential Diagnosis
- UTI
- STD
- Intestional parasites
- Traveler's diarrhea
Diagnosis
Work-up
- ELISA
- PCR from stool or urine
- Stool and Urine for ova/parasites
- biopsy may be needed for those who do not show ova/parasites in stool/urine
- CBC, Alk Phos, GGT, ALT/AST, Cr, Blood Cx
- Consider US for hepatosplenic (periportal fibrosis) or urinary disease (hydro)
- Echo and CXR for pulmonary HTN and/or cor pulmonale
- Consider CT or MRI for CNS disease or further w/u of periportal fibrosis
Evaluation
Management
- Praziquantel 20mg/kg PO for two doses in 1 day
- S.japnonicum requires 3 doses in 1 day