Treatment of schistosomiasis (HAS)
- schistosomiasis is a parasite infection by flatworms which live in the circulatory system. There are five species of worms that are responsible of this infection :
- Schistosoma mansoni (urogenital schistosomiasis ) ;
- Schistosoma mansoni (intestinal and sometimes hepato-splenic schistosomiasis ) ;
- Schistosoma mansoni, Schistosoma japonicum and Schistosoma mekongi (intestinal schistosomiasis with hepathic complications) ;
- Schistosoma mansoni, Schistosoma intercalatum (rectal and genital schistosomiasis ).
- Few cases have been registered in France. They are mainly:
- Contamination happens when bathing in fresh water (presence of molluscs).
- In order to diagnose schistosomiasis , the doctor must ask questions to the patient :
- Travel to endemic country,
- Geographical origin,
- Immersion in stagnant fresh water with pruritus following bathing,
- Antecedents of schistosomiasis .
- General signs :
- Weight loss,
- Dyspnea (difficulties to breath) asthma form,
- Articulation pains,
- Muscular pains.
- Uro-genital schistosomiasis :
- Urinary signs
- Difficulties to urinate,
- Pollakiuria (frequent emissions but with small quantities),
- Sub-pubic pains during micturition,
- Terminal haematuria,
- Infections of the urinary system,
- Parenchymatic infections.
- Genital signs
- For man : hematospermia, funiculitis, chronic epididymitis;
- For woman : dyspareunia, leukorrhoea , hemorrhages, vulvar pruritus.
- Intestinal or rectal and genital schistosomiasis :
- Colic pains,
- Anus-rectal pains,
- Hepatomegaly (Enlargement of the liver beyond its normal size),
- Portal hypertension (digestive hemorrhages, splenomegaly , ascites),
- Among other things and considering the infected area by the schistosomiasis :
- Parasitological check-up,
- Urine, faeces, anatomo-pathological sampling,
- IF, Elisa, Western blot,
- Liver check-up,
- Ultrasound scan,
- Proctoscopy ,
- Sterility check-up,
- Urinary strips.
Complications of the infection
- Cardiac and pulmonary :
- Left ventricular deficiency.
- Neurological :
- Intra-cranial hypertension,
- Convulsions attacks,
- Severe myelitis,
- Medullary compression.
- Cutaneaous (schistosomiasis on the external genital organs, perineal and gluteal areas) .
- Recurring salmonella.
- Cancerological (epidermoid cystic carcinoma, colic adenocarcinoma).
- Treatment of the infection :
- Anthelmintic: praziquantel.
- Treatment of the complications :
- Ablation of kidney,
- Elimination of the stones,
- For portal hypertension: drugs (diuretic , beta adrenergic blocking agent ...), endoscopy, surgery.
_final_web.pdf schistosomiasis compliquée
, HAS, october 2007.
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Manejo de la bilharziasis complicada (Esquistosomiasis)