Medical history (history of illness) represents an important component in the diagnosis of schistosomiasis (bilharzia). Family history What is the general health status of your relatives? Social history What is your profession? Do you frequently travel abroad? If so, where exactly? Current medical history/systemic history (somatic and psychological complaints). Did you have any contact with … Schistosomiasis: Medical History
Respiratory System (J00-J99) Bronchitis Blood, blood-forming organs – immune system (D50-D90). Anemia (anemia) Skin and subcutaneous (L00-L99) Generalized urticaria (hives). Cardiovascular system (I00-I99) Pulmonary hypertension (PH; pulmonary hypertension). Infectious and parasitic diseases (A00-B99). Acute hepatitis (inflammation of the liver). Amoebic dysentery (tropical intestinal infection). Ankylostomiasis – disease caused by the hookworms. Acute hepatitis (inflammation of … Schistosomiasis: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by schistosomiasis: Respiratory system (J00-J99) Bronchitis Pulmonary schistosomiasis – consequences include pulmonary hypertension (high pressure in the lungs) and cor pulmonale (dilatation (widening) and/or hypertrophy (enlargement) of the right ventricle (main chamber) of the heart as a result of pulmonary hypertension … Schistosomiasis: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; further: Inspection (viewing). Skin, mucous membranes, and sclerae (white part of the eye) [pruritus (itching), edema (water retention), generalized urticaria (hives)] Abdomen (abdomen) Shape of the abdomen? Skin color? … Schistosomiasis: Examination
1st order laboratory parameters – obligatory laboratory tests. Small blood count [anemia (anemia), if applicable]. Differential blood count [eosinophilia] Ferritin – if iron deficiency anemia is suspected. Inflammatory parameter – CRP (C-reactive protein). Urine sediment (urine examination) [hematuria (blood in urine)] Stool and urine examination for enteropathogenic germs, fungi, parasites and worm eggs [Evidence is … Schistosomiasis: Test and Diagnosis
Therapeutic target Elimination of the parasites Therapy recommendations Anthelmintics (drugs against worm diseases): praziquantel (first-line agent); alternatively, for S. haematobium, metrifonate; for S. mansoni, oxamniquine (possibly with supplemental administration of corticosteroids). See also under “Further therapy“.
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic clarification. Abdominal ultrasonography (ultrasound examination of abdominal organs) – for suspected involvement of abdominal organs [detection of granulomatous and fibrotic lesions in bladder, intestine and liver in advanced disease]. Colonoscopy … Schistosomiasis: Diagnostic Tests
Prophylactic measures Avoid bathing in inland waters Hygiene measures (drinking water treatment, sanitation). Control of the intermediate hosts of the pathogens
The following symptoms and complaints may indicate schistosomiasis (bilharzia): Pruritus (itching) Fleabite dermatitis in the area of the skin site through which the schistosoma has penetrated Generalized urticaria (hives). Fever, chills Cephalgia (headache) Cough Edema (water retention) Intermittent diarrhea (diarrhea), bloody. Abdominal pain (abdominal pain) Rectal bleeding (bleeding from the rectum). Fatigue Anemia (anemia) Dysuria … Schistosomiasis: Symptoms, Complaints, Signs
Pathogenesis (development of disease) The disease is mainly caused by five human pathogenic trematodes: Schistosoma (S.) haematobium, S. mansoni, S. japonicum, S. intercalatum, and S. mekongi. Pathogen reservoir are snails as intermediate hosts in fresh waters (rivers, lakes), from which schistosoma larvae, so-called cercariae, are released. Transmission occurs percutaneously (through the skin) in water. The … Schistosomiasis: Causes
General measures Observance of the general hygiene measures! In the occurrence of fever: Bed rest and physical rest (even if fever is only mild; if limb pain and lassitude occur without fever, bed rest and physical rest is also required, because myocarditis/heart muscle inflammation could occur as a result of the infection). Fever below 38.5 … Schistosomiasis: Therapy
