Bilharziasis cutanea tarda: a rare presentation of schistosomiasis

Anais Brasileiros de Dermatologia, 2014

Schistosomiasis mansoni is a systemic disease caused by a helminth of the schistosoma genus. The disease is generally asymptomatic or gastrointestinal symptoms may predominate. Skin lesions related to the disease are rarely diagnosed, even in endemic areas. The authors report the case of a young girl diagnosed with cutaneous schistosomiasis with involvement of the abdomen, back and scapular region. Schistosoma eggs were found in the lesions by histopathologic exam. There was no evidence of systemic involvement. Schistosomiasis must be included in the list of differential diagnosis of skin damage, especially in endemic areas, due to the potential consequences, in case of late diagnosis and treatment.

BMJ, 2011

points Schistosomiasis, or bilharzia, is a common intravascular infection caused by parasitic Schistosoma trematode worms It is prevalent in Africa, the Middle East, South America, and Asia Acute schistosomiasis, or Katayama syndrome, can present as fever, malaise, myalgia, fatigue, non-productive cough, diarrhoea (with or without blood), haematuria (S haematobium), and right upper quadrant pain Chronic and advanced disease results from the host's immune response to schistosome eggs deposited in tissues and the granulomatous reaction evoked by the antigens they secrete S mansoni, S japonicum, S intercalatum, and S mekongi cause intestinal disease; S haematobium causes urinary disease Neuroschistosomiasis is arguably the most severe clinical syndrome associated with schistosome infection Microscopic examination of excreta (stool, urine) is the gold standard diagnostic test but requires the adult worms to be producing eggs; serological tests can diagnose less advanced infections Praziquantel 60 mg/kg in three doses over one day (S japonicum and S.mekongi); and 40 mg/kg in doses over one day (S mansoni, S haematobium, S intercalatum) remains the treatment of choice although others are being investigated Preventive chemotherapy is with a single oral dose of praziquantel 40 mg/kg For personal use only: See rights and reprints

Revista do Instituto de Medicina Tropical de São Paulo

Schistosomiasis haematobia or urinary schistosomiasis is one of the main public health problems in Africa and the Middle East. A single dose of 40 mg praziquantel per kg body weight continues to be the treatment of choice for this infection. The aims of this follow-up were to study the post-treatment course of a patient infected with S. haematobium and not submitted to re-exposure, and to identify complications of the disease and/or therapeutic failure after praziquantel treatment by histopathological analysis. Treatments were repeated under medical supervision to ensure the correct use of the drug. In view of the suspicion of lesions in cystoscopy, the patient was submitted to bladder biopsy. The histopathological characteristics observed in biopsies obtained, after each treatment, indicated viability of parasite eggs and activity of granulomas.

Memórias do Instituto …, 2005

Several cases of therapeutic failure of praziquantel used for the treatment of urinary schistosomiasis have been reported. Alternative drugs, like niridazol and metrifonate, have shown a lower therapeutic effect and more side effects than praziquantel. Twenty-six Brazilian military men (median age of 29 years) with a positive urine parasitological exam who were part of a United Nation peace mission in Mozambique in 1994 were treated with 40 mg/ kg body weight praziquantel, single dose. They swimmed in Licungo river (Mocuba city, Mozambique) during the weekends. After this, they presented haematuria, dysuria, polakiuria, and lumbar pain. Control cystoscopy examinations carried out between 6 and 24 months after each treatment (including two additional treatments at a minimum interval of 6 months) revealed the presence of viable eggs. Granulomas in the vesical submucosa were observed in 46.2% (12/26) of the individuals. A vesical biopsy confirmed the presence of granulomas in all of these patients and the presence of viable eggs in 34.3% (9/26) of individuals who no longer excreted eggs in urine. The eggs filled with miracidia showed characteristics of viability. Histopathological examination using different strains demonstrated therapeutic failure and the need for repeated treatment. In this study, we demonstrated a low efficacy of praziquantel in the treatment of schistosomiasis haematobia, and the necessity of the urinary bladder biopsy as criterion of cure.

Revista da Sociedade Brasileira de Medicina Tropical, 2008

Seven cases of patients with ectopic schistosomiasis from the State of Sergipe, Brazil, are presented (five involving skin, one ovarian and one adrenal). Data were collected from surveying the clinical records and anatomopathological reports in the files of the dermatology and pathology clinics of the University Hospital of the Federal University of Sergipe, from 1995 to 2005. The patients' mean age at diagnosis was 21.1 years. In the dermatological cases, full cures were achieved after treatment with oxamniquine. In the ovarian case, there was an association with embryonic carcinoma: this patient underwent surgery with adjuvant chemotherapy and praziquantel treatment, with satisfactory evolution. The adrenal case was associated with adenoma.

Urology Case Reports, 2020

Hematobium species of this parasite tends to bladder and mesenteric arteries and it causes lesions in the bladder wall, urethra, and renal tubes. A 25-year-old man living in Tehran (a non-endemic and very rare area for schistosoma) suffers from symptoms such as hematuria with suprapubic pain, dysuria, fever, nausea and vomiting. Urine analysis showed a lot of red blood cells, after using cystoscopy of the area and receiving a bladder biopsy, a definitive diagnosis of schistosomiasis was made and after determining the extent of damage to the urinary tract, appropriate treatment with surgery and praziquantel (40 mg/kg) were prescribed.

PLOS Neglected Tropical Diseases, 2015

Nigerian journal of medicine : journal of the National Association of Resident Doctors of Nigeria, 2019

Urinary schistosomiasis is the most frequently encountered bilhaziasis infestation in Africa with wide range of clinical manifestation. We present three cases of urinary schistosomiasis with different manifestations. The aim is to emphasize the importance of high index of suspicion in the absence of the classical features of urinary schistosomiasis. CASE ONE: He presented with left sided lower abdominal pain, recurrent hematuria and storage lower urinary tract symptoms. Urologic scan showed a hyperechoic mass measuring 10.2mm at the left ureterovesical junction and casting an acoustic shadow posteriorly. Intraoperative findings were that of a stenosed left distal ureter about 5mm from the ureteric orifice. We performed a left stented refluxing ureteroneocystostomy with excision of the stenosed ureter. Histologic section was suggestive of ureteric schistosomiasis. CASE TWO: She presented with predominantly storage lower urinary tract symptoms and lower abdominal pain. Urologic scan showed thick walled urinary bladder with a central mass. Cystoscopy revealed a small capacity bladder with a polypoid mass arising from the dome of the bladder which was excised endoscoically and sent for histological analysis. The histology report was suggestive of schistosomiasis. CASE THREE: She presented with storage lower urinary tract symptoms and painful terminal hematuria. Abdominal sonography and CT showed gross bilateral hydroureteronephrosis down to the vesicoureteric junction. Cystoscopy showed small capacity bladder (<60ml) with sandy patches at the trigone. She had augmentation cystoplasty and ureteric re-implantation. CONCLUSION: A strategy for public enlightment, screening and early detection of schistosoma infestation of the urinary tract will provide a better assessment of this endemic parasitic infection with rising global public health concern.

Schistosomiasis is a parasite disease that affects both humans and animals and is brought on by the blood flukes of the genus Schistosoma. It is one of the world's most enduring neglected tropical diseases. Sub-Saharians make up more than 90% of them, and a significant portion of Ethiopians are afflicted and at risk. It spread across the entire nation and was correlated with the rapid development of water resources and population growth. The two species of freshwater snails, Biomphalaria pfeifferi and Biomphalaria sudanica, are responsible for the parasite's transmission in Ethiopia. Compared to the three primary schistosomes that infect people, Schistosoma mansoni, Schistosoma haematobium, Schistosoma japonicum, Schistosoma intercalatum, and Schistosoma mekongi have less of an epidemiological impact. Geographically, S. haematobium and S. mansoni are more common in Africa than other species. Epidemiological coverage is also influenced by seasonal distributions throughout the postrainy season, as well as the cold and dry seasons. The organs and systems implicated in its pathogenic dissemination include the intestines, urogenital systems, the pulmonary system, the liver, spleen, and the brain. Ecological change and sociocultural influences are risk factors for water contamination. Regarding clinical symptoms, the penetration of cercariae into the dermis, cercarial dermatitis, acute schistosomiasis, and the chronic stage of infection are significant. Mammals and snails serve as the two hosts for the schistosome life cycle. It can be diagnosed through clinical exams and laboratory techniques. Praziquantel can be used to treat this condition, and it can be prevented by taking precautions during ecological shifts that may result in epidemics. Other measures to take include providing clean water, maintaining good hygiene, controlling mosquitoes, and spreading health awareness.

Journal of Clinical Medicine, 2021

Schistosomiasis is a helminthic infection and one of the neglected tropical diseases (NTDs). It is caused by blood flukes of the genus Schistosoma. It is an important public health problem, particularly in poverty-stricken areas, especially those within the tropics and subtropics. It is estimated that at least 236 million people worldwide are infected, 90% of them in sub-Saharan Africa, and that this disease causes approximately 300,000 deaths annually. The clinical manifestations are varied and affect practically all organs. There are substantial differences in the clinical presentation, depending on the phase and clinical form of schistosomiasis in which it occurs. Schistosomiasis can remain undiagnosed for a long period of time, with secondary clinical lesion. Here, we review the clinical profile of schistosomiasis. This information may aid in the development of more efficacious treatments and improved disease prognosis.