Introduction
Schistosomiasis is a disease caused by five species of the parasitic genus Schistosoma
Humans are infected with schistosomes after contact with freshwater containing cercariae released by infected snails
Symptoms & Signs
Schistosomiasis has three stages of clinical symptomatology corresponding to the life cycle of the parasite in the human host
Stage 1: Cercarial Dermatitis (“Swimmer’s Itch”)
The first stage is characterized by a very itchy maculopapular rash which occurs at the time of penetration
Stage 2: Acute schistosomiasis (Katayama syndrome)
The second stage is characterized by a serum sickness like syndrome with elevated levels of immunoglobulin E and eosinophilia.
-Fever,chills, myalgias, headache, cough, sweating, lymphadenopathy, hepatosplenomegaly, diarrhea, abdominal pain, and pulmonary infiltrates
Stage 3: Chronic schistosomiasis
The third, chronic stage is characterized by granulomatous reactions to egg deposition in the intestine, liver, bladder, lung and CNS
-Chronic diarrhea, abdominal pain, blood loss, portal hypertension, splenomegaly, bleeding esophageal varices, pulmonary hypertension, right-sided congestive heart failure, transverse myelitis, hematuria, bladder obstruction, hydroureter, and hydronephrosis
Diagnosis
Diagnostic methods: Detection of schistosome eggs in stool or urine, ELISA, biopsy of the rectum, colon, liver or bladder
-Eggs of Schistosoma haematobium possess a characteristic terminal spine
Treatment
The drug of choice for treatment of schistosomiasis is praziquantel
Chemoprophylaxis with artemether has shown efficacy