Schistosomiasis

Last reviewed: 7 Sep 2022
Last updated: 01 Jul 2022

Summary

Definition

History and exam

Key diagnostic factors

  • geographic exposure
  • abdominal pain
  • hematuria
  • hematemesis
More key diagnostic factors

Other diagnostic factors

  • rash
  • fever
  • dysuria
  • hepatosplenomegaly
  • dyspnea
  • bloody diarrhea
  • pelvic pain
  • infertility or history of ectopic pregnancy
  • ascites
  • genital ulcers
Other diagnostic factors

Risk factors

  • skin exposure to contaminated freshwater
  • travel to endemic areas
  • age 4 to 15 years
  • occupational exposure
More risk factors

Diagnostic investigations

1st investigations to order

  • stool or urine microscopy
  • urinalysis
  • complete blood count
  • blood culture
  • thick and thin blood smears
More 1st investigations to order

Investigations 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
More investigations to consider

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 Gundacker, MD

Assistant Professor

Division of Infectious Diseases

Department of Medicine

Medical College of Wisconsin

Milwaukee

WI

Disclosures

NG declares that he has no competing interests.

Acknowledgements

Dr J. Martin Rodriguez and Dr Nathan 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.

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