Schistosomiasis - Causes, Symptoms and Treatments
Schistosomiasis, also known as bilharzia, is a slowly progressive disease caused by blood flukes of the class Trematoda. There are three major types: Schistosoma mansoni and S. japonicum infect the intestinal tract; S. haematobium infects the urinary tract. The degree of infection determines the intensity of illness. Complications - such as portal hypertension, pulmonary hypertension, heart failure, ascites, hernatemesis from ruptured esophageal varices, and renal failure - can be fatal.
Causes of Schistosomiasis:
The mode of transmission is bathing, swimming, wading, or working in water contaminated with Schistosoma larvae. These larvae penetrate the skin or mucous membranes and eventually work their way to the liver's venous portal circulation. There, they mature in 1 to 3 months The adults then migrate to other parts of the body.
The female cercariae lay spiny eggs in blood vessels surrounding the large intestine or bladder. After penetrating the mucosa of these organs, the eggs are excreted in feccs or urine. If the eggs hatch in fresh water, the first-stage larvae (miracidia) penetrate freshwater snails, which act as passive intermediate hosts. Cercariae produced in snails escape into water and begin a new life cycle.
Signs and Symptoms of Schistosomiasis:
Initial signs and symptoms of schistosomiasis depend on the site of infection and the stage of the disease. Initially, a transient, pruritic rash develops at the site of cercariae penetration, along with fever, myalgia, and cough. Later signs and symptoms may include hepatomegaly, splenomegaly, and lymphadenopathy. Worm migration and egg deposition may cause such complications as flaccid paralysis, seizures, and skin abscesses.
Diagnosis of Schistosomiasis:
Typical symptoms and a history of travel to endemic areas suggest the diagnosis; ova in the urine or stool or a mucosal lesion biopsy confirms it. The white blood cell count shows eosinophilia.
Treatment of Schistosomiasis:
The treatment of choice is the anthelmintic drug praziquantel. Between 3 and 6 months after treatment, the patient will need to be examined again. If this checkup detects any living eggs, treatment may be resumed.
To help prevent schistosomiasis, teach those in endemic areas the Importance of a pure water supply and to avoid contaminated water. If they must enter this water, tell them to wear protective clothing and to dry themselves afterward.
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