When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Schistosomiasis

Last reviewed: 17 Aug 2025
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.

Revisores por pares

Richard Olds, MD, FACP

Professor

Medical College of Wisconsin

Milwaukee

WI

Divulgaciones

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

Divulgaciones

JRL declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

World Health Organization. Schistosomiasis (Bilharzia). 2022 [internet publication].Texto completo

World Health Organization. WHO guideline on control and elimination of human schistosomiasis. Feb 2022 [internet publication].Texto completo

McManus DP, Dunne DW, Sacko M, et al. Schistosomiasis. Nat Rev Dis Primers. 2018 Aug 9;4(1):13. Resumen

Mutapi F, Maizels R, Fenwick A, et al. Human schistosomiasis in the post mass drug administration era. Lancet Infect Dis. 2017 Feb;17(2):e42-8.Texto completo  Resumen

Weerakoon KG, Gobert GN, Cai P, et al. Advances in the diagnosis of human schistosomiasis. Clin Microbiol Rev. 2015 Oct;28(4):939-67. Resumen

Centers for Disease Control and Prevention. Parasites - Schistosomiasis: resources for health professionals. Oct 2020 [internet publication].Texto completo

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
  • Schistosomiasis images
  • Diferenciales

    • Crohn disease
    • Ulcerative colitis
    • Colon cancer
    Más Diferenciales
  • Guías de práctica clínica

    • CDC health information for international travel (Yellow Book 2024): schistosomiasis
    • WHO guideline on control and elimination of human schistosomiasis
    Más Guías de práctica clínica
  • padlock-lockedInicie sesión o suscríbase para acceder a todo el BMJ Best Practice

El uso de este contenido está sujeto a nuestra cláusula de exención de responsabilidad