Related articles: Schistosomiasis
Definition
Schistosomiasis is an infection with trematodes (worms) of the genus Schistosoma . These pathogens penetrate human skin during baths or immersions in contaminated fresh water, thus infecting the vascular system of the gastro-intestinal or genitourinary tract. Five species of schistosoma, in particular, infect humans; Intermediate guests are freshwater molluscs.
Schistosomiasis can be imported by travelers from endemic areas.
Most common symptoms and signs *
- Miscarriage
- Changes in the menstrual cycle
- Ascites
- Asthenia
- Chills
- Cachexia
- Coma
- Convulsions
- Diarrhea
- Dyspnoea
- Dysuria
- Abdominal pain
- Pelvic pain
- Muscle pains
- Hematemesis
- Gastrointestinal hemorrhage
- Hemoptysis
- Eosinophilia
- Hepatomegaly
- Erythema
- Temperature
- Intracranial hypertension
- Portal hypertension
- infertility
- Hypovolemia
- Lethargy
- Swollen lymph nodes
- Headache
- Melena
- Nausea
- Urticaria
- papules
- pollakiuria
- itch
- Blood in the ejaculate
- Blood in the stool
- Blood in the urine
- Vaginal bleeding
- Nephritic syndrome
- Nephrotic syndrome
- splenomegaly
- Sweating
- Rectal tenesmus
- Bladder tenesmus
- Cough
Further indications
The disease presents with acute and chronic forms, which vary according to the species in question and to the organs or tissues involved.
The acute symptoms of schistosomiasis consist of a papular and pruritic rash (dermatitis), followed by fever, chills, cough, nausea, headache, abdominal pain, diarrhea, myalgia and malaise. The manifestations also include urticaria and marked eosinophilia. Acute schistosomiasis (or Katayama fever) generally lasts for several weeks.
Chronic symptoms depend on the infecting species and occur mainly due to the host's responses to parasite eggs, which remain trapped in certain tissues. Manifestations include ulceration of the intestinal mucosa and bladder wall, dysuria, hematuria, pollakiuria, diarrhea with blood secretions, malabsorption, polyp formation and intestinal obstruction.
Over time, chronic cystitis develops and blood loss often causes anemia. Secondary infections of the genitourinary tract are also frequent, which induce the appearance of numerous symptoms, including genital blood secretions and losses, menstrual disorders, infertility and complications during gestation.
The eggs present in the vessels that supply the liver can induce fibrosis, cirrhosis, portal hypertension and high digestive bleeding (from rupture of esophageal or gastric varices); at the level of the lungs, on the other hand, they can cause granulomas and pulmonary hypertension, while in the CNS they can cause convulsions and focal neurological deficits.
Diagnosis is based on the microscopic identification of eggs in faeces, urine or biopsy specimens. The therapy is based on praziquantel (only one day of oral treatment is enough). To prevent infection it is important to carefully avoid contact with river water (fresh water) in endemic areas.
