09/07/2026
Schistosomiasis (Bilharzia)
1. Etiology & Species:
-Caused by trematodes (blood flukes) of the genus Schistosoma.
-The three main species:
1-Schistosoma haematobium:Affects Urinary Tract
2-Schistosoma mansoni: GIT and Liver
3-Schistosoma japonicum: GIT and Liver
2. Clinical Features:
A. Immediate / Local (Swimmer's Itch):transient, itchy maculopapular rash at the site of cercarial pe*******on, occurring within 24–48 hours.
B. Acute Schistosomiasis (Katayama Fever):Occurs 3–8 weeks later,characterized by fever, headache, chills, cough, urticaria (hives), hepatosplenomegaly, and profound eosinophilia
C. Chronic Schistosomiasis: Caused By granulomatous host immune response to eggs trapped in the tissues
**Urinary Schistosomiasis:
-Terminal, painless hematuria (blood at the end of micturition) and dysuria.
-Fibrosis and calcification of the bladder wall ("sandy patches" on cystoscopy), ureteric strictures, hydronephrosis, secondary bacterial urinary tract infections, renal failure
**Intestinal & Hepatosplenic Schistosomiasis:
-Chronic bloody diarrhea, abdominal pain, and colonic polyposis
-portal hypertension, leading to splenomegaly and life-threatening esophageal varices.
3. Investigations:
-Microscopy (Gold Standard)
-Tissue Biopsy
-Serology (ELISA)
-Imaging: Ultrasound or CT
4.Management:
-Drug of Choice: Praziquantel is highly effective against adult worms of all species.40 mg/kg (for S. haematobium and S. mansoni) or 60 mg/kg (for S. japonicum) given orally in divided doses over a single day.
-Acute Phase Treatment: Katayama fever is often treated with corticosteroids alongside praziquantel
