15.3
Schistosomiasis
Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 15, Parasitic Conditions.
Clinical Description
Schistosomiasis is an infection with blood flukes of the genus Schistosoma.
Signs and Symptoms
For S. haematobium & S. mansoni
- “swimmer’s itch”: brief, localized urticaria/pruritus +/- eosinophilia
- Katayama fever: acute illness with fever, oesinophilila +/- pneumonitis
- CNS involvement (ectopic eggs or worms)
- meningoencephalitis
- seizures
- pulmonary granulomas (or egg emboli)
- Right ventricular failure/congestive cardiac failure for Schistosoma haematobium
- bladder granulomas:
- terminal haematuria
- obstructive uropathy (± secondary infection)
- hydroureter
- bladder calcification
- squamous bladder cancer
- genital tract granulomas
- haemospermia
- inflammation in vulva/vagina/cervix
- infertility (Fallopian tube involvement)
For Schistosoma mansoni
- GI tract granulomas
- colonic ulceration/bleeding; tenesmus
- portal hypertension
- hepatosplenomegaly
- ‘pipestem fibrosis’ of liver
- porto-caval shunting
Treatment
- Give Praziquantel 40 mg/kg as a single dose
- Children below 4 years of age Praziquantel
- 20mg/kg as stat dose
Note: Assess all lesions around genitalia to check for genital schistosomiasis
- refer male and female genital schistosomiasis for laboratory diagnostics
Check doses against the printed guideline and your clinical judgement before treating a patient. Spotted an error? Report it from the contact links below.
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