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Schistosomiasis

Last reviewed: 21 Oct 2024
Last updated: 12 Mar 2024

Summary

Definition

History and exam

Key diagnostic factors

  • geographic exposure
  • abdominal pain
  • hematuria
  • hematemesis
Full details

Other diagnostic factors

  • rash
  • fever
  • dysuria
  • hepatosplenomegaly
  • dyspnea
  • bloody diarrhea
  • pelvic pain
  • infertility or history of ectopic pregnancy
  • ascites
  • genital ulcers
Full details

Risk factors

  • skin exposure to contaminated freshwater
  • travel to endemic areas
  • age 4 to 15 years
  • occupational exposure
Full details

Diagnostic tests

1st tests to order

  • stool or urine microscopy
  • urinalysis
  • complete blood count
  • blood culture
  • thick and thin blood smears
Full details

Tests to consider

  • serology
  • liver function tests (LFTs)
  • renal function tests
  • abdominal ultrasound
  • tissue biopsy
  • computed tomography (CT) or magnetic resonance imaging (MRI) abdomen
  • MRI brain and spinal cord
  • chest x-ray
  • CT chest
  • urinary circulating anodic antigen (CAA)
  • schistosome DNA/RNA
Full details

Treatment algorithm

ACUTE

cercarial dermatitis

acute schistosomiasis

ONGOING

chronic schistosomiasis

persistent infection despite praziquantel treatment

Contributors

Authors

J. Martin Rodriguez, MD

Professor of Medicine

Division of Infectious Diseases

University of Alabama at Birmingham

Birmingham

AL

Disclosures

JMR declares that he has no competing interests.

Nathan D. Gundacker, MD

Assistant Professor

Division of Infectious Diseases

Department of Medicine

Medical College of Wisconsin

Milwaukee

WI

Disclosures

NDG declares that he has no competing interests.

Acknowledgements

Dr J. Martin Rodriguez and Dr Nathan D. Gundacker would like to gratefully acknowledge the late Dr Ildefonso Tellez, who was previously a co-contributor to this topic. Dr Rodriguez would also like to gratefully acknowledge Dr Arlene Dent and Dr Charles H. King, previous contributors to this topic.

Disclosures

IT declared that he had no competing interests. AD and CHK also declare that they have no competing interests.

Peer reviewers

Richard Olds, MD, FACP

Professor

Medical College of Wisconsin

Milwaukee

WI

Disclosures

RO declares that he has no competing interests.

Jose Roberto Lambertucci, MD

Professor

Faculty of Medicine

Federal University of Minas Gerais

Belo Horizonte

Minas Gerais

Brazil

Disclosures

JRL declares that he has no competing interests.

  • Schistosomiasis images
  • Differentials

    • Crohn disease
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    • Colon cancer
    More Differentials
  • Guidelines

    • CDC health information for international travel (Yellow Book 2024): schistosomiasis
    • WHO guideline on control and elimination of human schistosomiasis
    More Guidelines
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