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Comelli A, Genovese C, Gobbi F, Brindicci G, Capone S, Corpolongo A, Crosato V, Mangano VD, Marrone R, Merelli M, Prato M, Santoro CR, Scarso S, Vanino E, Marchese V, Antinori S, Mastroianni C, Raglio A, Bruschi F, Minervini A, Donà D, Garazzino S, Galli L, Lo Vecchio A, Galli A, Dragoni G, Cricelli C, Colacurci N, Ferrazzi E, Pieralli A, Montresor A, Richter J, Calleri G, Bartoloni A, Zammarchi L. Schistosomiasis in non-endemic areas: Italian consensus recommendations for screening, diagnosis and management by the Italian Society of Tropical Medicine and Global Health (SIMET), endorsed by the Committee for the Study of Parasitology of the Italian Association of Clinical Microbiologists (CoSP-AMCLI), the Italian Society of Parasitology (SoIPa), the Italian Society of Gastroenterology and Digestive Endoscopy (SIGE), the Italian Society of Gynaecology and Obstetrics (SIGO), the Italian Society of Colposcopy and Cervico-Vaginal Pathology (SICPCV), the Italian Society of General Medicine and Primary Care (SIMG), the Italian Society of Infectious and Tropical Diseases (SIMIT), the Italian Society of Pediatrics (SIP), the Italian Society of Paediatric Infectious Diseases (SITIP), the Italian Society of Urology (SIU). Infection 2023; 51:1249-1271. [PMID: 37420083 PMCID: PMC10545632 DOI: 10.1007/s15010-023-02050-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 05/08/2023] [Indexed: 07/09/2023]
Affiliation(s)
- Agnese Comelli
- Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Camilla Genovese
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
- II Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Federico Gobbi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Italy
- University of Brescia, Brescia, Italy
| | - Gaetano Brindicci
- AOU Consorziale Policlinico di Bari, Infectious Diseases Unit, Bari, Italy
| | - Susanna Capone
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili of Brescia, Brescia, Italy
| | - Angela Corpolongo
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' (IRCCS), Rome, Italy
| | - Verena Crosato
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili of Brescia, Brescia, Italy
| | - Valentina Dianora Mangano
- Department of Translational Research, N.T.M.S, Università di Pisa, Pisa, Italy
- Programma Di Monitoraggio Delle Parassitosi e f.a.d, AOU Pisana, Pisa, Italy
| | - Rosalia Marrone
- National Institute for Health, Migration and Poverty, Rome, Italy
| | - Maria Merelli
- Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy
| | - Marco Prato
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | | | - Salvatore Scarso
- National Center for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Elisa Vanino
- Unit of Infectious Diseases, Ospedale "Santa Maria delle Croci", AUSL Romagna, Ravenna, Italy
| | - Valentina Marchese
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
| | - Spinello Antinori
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Claudio Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Annibale Raglio
- Committee for the Study of Parasitology of the Italian Association of Clinical Microbiologists (CoSP-AMCLI), Milan, Italy
| | - Fabrizio Bruschi
- Department of Translational Research, N.T.M.S, Università di Pisa, Pisa, Italy
- Programma Di Monitoraggio Delle Parassitosi e f.a.d, AOU Pisana, Pisa, Italy
| | - Andrea Minervini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Department of Urology, University of Florence, Florence, Italy
| | - Daniele Donà
- Division of Paediatric Infectious Diseases, Department for Women's and Children's Health, University of Padua, Padua, Italy
| | - Silvia Garazzino
- Paediatric Infectious Disease Unit, Regina Margherita Children's Hospital, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Luisa Galli
- Infectious Diseases Unit, Meyer Children's Hospital, IRCCS, Florence, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Andrea Lo Vecchio
- Department of Translational Medical Sciences, Paediatric Infectious Disease Unit, University of Naples Federico II, Naples, Italy
| | - Andrea Galli
- Gastroenterology Research Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Gabriele Dragoni
- Gastroenterology Research Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Claudio Cricelli
- Health Search-Istituto di Ricerca della SIMG (Italian Society of General Medicine and Primary Care), Florence, Italy
| | - Nicola Colacurci
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Enrico Ferrazzi
- Department of Woman, New-Born and Child, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Annalisa Pieralli
- Ginecologia Chirurgica Oncologica, Careggi University and Hospital, Florence, Italy
| | - Antonio Montresor
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Joachim Richter
- Institute of International Health, Charité Universitätsmedizin, Corporate Member of Freie und Humboldt Universität Berlin and Berlin Institute of Health, Berlin, Germany
| | - Guido Calleri
- Amedeo Di Savoia Hospital, ASL Città di Torino, Turin, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy.
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Baluku JB, Olum R, Sanya RE, Ocama P. Respiratory morbidity in Schistosoma mansoni infection: a rapid review of literature. Ther Adv Infect Dis 2023; 10:20499361231220152. [PMID: 38152611 PMCID: PMC10752101 DOI: 10.1177/20499361231220152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/24/2023] [Indexed: 12/29/2023] Open
Abstract
Background Schistosomiasis contributes to 2.5 million disability-adjusted life years globally. Acute and chronic respiratory morbidity of Schistosoma mansoni (S. mansoni) is poorly documented in the literature. We conducted a rapid literature review of the burden of respiratory symptoms and lung function abnormalities among patients with S. mansoni. We also report the immunologic and lung imaging findings from the studies reviewed. Methods We carried out a comprehensive literature search in Embase and MEDLINE from the inception of the databases to 13th March 2023. Results A total of 2243 patients with S. mansoni were reported from 24 case reports, 11 cross-sectional studies, 7 case series, 2 cohort studies and 2 randomized controlled trials. The prevalence of any respiratory symptom was 13.3-63.3% (total number of patients studied, n = 149). The prevalence of the individual symptoms among patients with S. mansoni in whom respiratory symptoms were sought for was as follows: cough (8.3-80.6%, n = 338), dyspnea (1.7-100.0%, n = 200), chest pain (9.0-57.1%, n = 86), sputum production (20.0-23.3%, n = 30) and wheezing (0.0 - 20.0%, n = 1396). The frequency of the symptoms tended to be higher in acute schistosomiasis. Restrictive lung disease was prevalent in 29.0% (9/31). The commonest chest imaging findings reported were nodules (20-90%, n = 103) and interstitial infiltrates (12.5-23.0%, n = 89). Peripheral blood eosinophilia was prevalent in 72.0-100.0% of patients (n = 130) with acute schistosomiasis and correlated with symptoms and imaging abnormalities. Three case reports in chronic S. mansoni reported elevated C-reactive protein, leucocyte, neutrophil and absolute eosinophil counts, eosinophil percentage, IgE and IgG4. Conclusion There is a high prevalence of respiratory morbidity among patients with S. mansoni, particularly in the acute stage of the infection, although the studies are relatively small. Larger studies are needed to characterize respiratory morbidity in chronic schistosomiasis and determine the underlying clinical and immunological mechanisms.
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Affiliation(s)
- Joseph Baruch Baluku
- Immunomodulation and Vaccines Programme, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Department of Internal Medicine, Makerere University College of Health Sciences, PO Box 26343, Kampala, Uganda
| | - Ronald Olum
- St. Francis Hospital, Nsambya, Kampala, Uganda
| | - Richard E. Sanya
- Immunomodulation and Vaccines Programme, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Chronic Diseases Management Unit, African Population and Health Research Center, Nairobi, Uganda
| | - Ponsiano Ocama
- Immunomodulation and Vaccines Programme, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda
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Gobbi F, Tamarozzi F, Buonfrate D, van Lieshout L, Bisoffi Z, Bottieau E. New Insights on Acute and Chronic Schistosomiasis: Do We Need a Redefinition? Trends Parasitol 2020; 36:660-667. [PMID: 32505540 DOI: 10.1016/j.pt.2020.05.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 05/13/2020] [Accepted: 05/18/2020] [Indexed: 12/29/2022]
Abstract
A precise timeframe to differentiate acute schistosomiasis (AS) and chronic schistosomiasis (CS) is not well defined. Based on recent published literature, lung nodular lesions in AS and CS seem to have the same pathophysiology, that is, eggs laid in situ by adult worms, during an ectopic migration. Moreover, the occurrence of lung nodules due to clusters of eggs and the systemic immunoallergic reaction of AS (Katayama syndrome) may be two separate clinical entities, which may overlap during the early phase of infection. Consequently, the classical distinction between AS and CS loses much of its conceptual validity. If adult worms play a more important role in the early phase of the disease the clinical management of AS should probably be revised.
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Affiliation(s)
- Federico Gobbi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar (Verona), Italy.
| | - Francesca Tamarozzi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar (Verona), Italy
| | - Dora Buonfrate
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar (Verona), Italy
| | - Lisette van Lieshout
- Department of Parasitology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Zeno Bisoffi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar (Verona), Italy; Università degli Studi di Verona, Verona, Italy
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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Abstract
Schistosomiasis is traditionally classified into an acute and a chronic phase, although a precise temporal distinction between the two phases has not been established. Lung involvement can be observed in both phases. We previously reported seven cases of pulmonary lesions due to chronic schistosomiasis in African immigrants. All cases were documented with CT scans and demonstrated complete resolution after treatment with praziquantel. Moreover, another case showed spontaneous disappearance of the nodule before treatment with praziquantel. These findings are similar to those observed in the acute phase of schistosomiasis, with well-defined or ground glass nodules that resolve spontaneously. According to these findings, we postulate the presence of an "intermediate" phase of schistosomiasis involving the lungs that can be defined as an "early chronic phase," and presents analogies to the acute phase. We also hypothesize that in the "early chronic phase," the female worms transit through the lungs where they may lay eggs. These passages not only cause transient, but also radiologically visible alterations. The pathophysiology of lung lesions in the late chronic phase is probably different: the adult worms settled in the mesenteric plexuses produce eggs for years. The eggs repeatedly migrate to the perialveolar capillary beds via portal-caval shunting. Thus, in this case it is the eggs and not the adult worms that reach the lungs in a scattered way. Based on our findings, we suggest the alternative hypothesis that the pulmonary involvement is a phase of the natural evolution of the infection, both from Schistosoma mansoni and Schistosoma haematobium.
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Affiliation(s)
- Federico Gobbi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS-Sacro Cuore Don Calabria Hospital, Verona, Italy
| | - Dora Buonfrate
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS-Sacro Cuore Don Calabria Hospital, Verona, Italy
| | - Andrea Angheben
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS-Sacro Cuore Don Calabria Hospital, Verona, Italy
| | - Zeno Bisoffi
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy.,Department of Infectious-Tropical Diseases and Microbiology, IRCCS-Sacro Cuore Don Calabria Hospital, Verona, Italy
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Abstract
Gastrointestinal motility and transport of water and electrolytes play key roles in the pathophysiology of diarrhea upon exposure to enteric parasites. These processes are actively modulated by the enteric nervous system (ENS), which includes efferent, and afferent neurons, as well as interneurons. ENS integrity is essential to the maintenance of homeostatic gut responses. A number of gastrointestinal parasites are known to cause disease by altering the ENS. The mechanisms remain incompletely understood. Cryptosporidium parvum, Giardia duodenalis (syn. Giardia intestinalis, Giardia lamblia), Trypanosoma cruzi, Schistosoma species and others alter gastrointestinal motility, absorption, or secretion at least in part via effects on the ENS. Recent findings also implicate enteric parasites such as C. parvum and G. duodenalis in the development of post-infectious complications such as irritable bowel syndrome, which further underscores their effects on the gut-brain axis. This article critically reviews recent advances and the current state of knowledge on the impact of enteric parasitism on the neural control of gut functions, and provides insights into mechanisms underlying these abnormalities.
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Affiliation(s)
- Marie C M Halliez
- Department of Biological Sciences, Inflammation Research Network, Host-Parasite Interaction NSERC-CREATE, University of Calgary Calgary, AB, Canada ; Protozooses transmises par l'alimentation, Rouen University Hospital, University of Rouen and Institute for Biomedical Research, University of Reims Champagne-Ardennes Rouen and Reims, France
| | - André G Buret
- Department of Biological Sciences, Inflammation Research Network, Host-Parasite Interaction NSERC-CREATE, University of Calgary Calgary, AB, Canada
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Pavlin BI, Kozarsky P, Cetron MS. Acute pulmonary schistosomiasis in travelers: case report and review of the literature. Travel Med Infect Dis 2012; 10:209-19. [PMID: 22981182 DOI: 10.1016/j.tmaid.2012.06.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2012] [Revised: 06/14/2012] [Accepted: 06/20/2012] [Indexed: 11/21/2022]
Abstract
We report the case of an American traveler who developed acute pulmonary schistosomiasis after swimming in a lake in Madagascar, and we review the literature on acute pulmonary schistosomiasis. Schistosomiasis is one of the world's most prevalent parasitic diseases, with three species (Schistosoma mansoni, Schistosoma haematobium and Schistosoma japonicum) causing the greatest burden of disease. Pulmonary manifestations may develop in infected travelers from non-endemic areas after their first exposure. The pathophysiology of acute pulmonary disease is not well-understood, but is related to immune response, particularly via inflammatory cytokines. Diagnosis of schistosomiasis may be either through identification of characteristic ova in urine or stool or through serology. Anti-inflammatory drugs can provide symptomatic relief; praziquantel, the mainstay of chronic schistosomiasis treatment, is likely not effective against acute disease; the only reliable prevention remains avoidance of contaminated freshwater in endemic areas, as there is no vaccine. Travelers who have been exposed to potentially contaminated freshwater in endemic areas should seek testing and, if infected, treatment, in order to avoid severe manifestations of acute schistosomiasis and prevent complications of chronic disease. Clinicians are reminded to elicit a detailed travel and exposure history from their patients.
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Li Y, Ross AG, Hou X, Lou Z, McManus DP. Oriental schistosomiasis with neurological complications: case report. Ann Clin Microbiol Antimicrob 2011; 10:5. [PMID: 21294922 PMCID: PMC3042902 DOI: 10.1186/1476-0711-10-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2010] [Accepted: 02/07/2011] [Indexed: 05/26/2023] Open
Abstract
We describe a case of cerebral schistosomiasis, caused by Asian (oriental) Schistosoma japonicum trematode blood flukes, in a young Chinese patient and its management. We also provide a brief update for physicians on the clinical features, diagnosis and treatment of schistosomiasis, with particular emphasis on neuroschistosomiasis, the most severe clinical outcome associated with this parasitic infection.
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Affiliation(s)
- Yuesheng Li
- Hunan Institute of Parasitic Diseases, World Health Organisation Collaborating Centre for Research and Control on Schistosomiasis in Lake Region, Yueyang, Hunan, People's Republic of China.
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Abstract
Acute schistosomiasis is a systemic hypersensitivity reaction against the migrating schistosomula and eggs. A variety of clinical manifestations appear during the migration of schistosomes in humans: cercarial dermatitis, fever, pneumonia, diarrhoea, hepatomegaly, splenomegaly, skin lesions, liver abscesses, brain tumours and myeloradiculopathy. Hypereosinophilia is common and aids diagnosis. The disease has been overlooked, misdiagnosed, underestimated and underreported in endemic areas, but risk groups are well known, including military recruits, some religious congregations, rural tourists and people practicing recreational water sports. Serology may help in diagnosis, but the finding of necrotic-exudative granulomata in a liver biopsy specimen is pathognomonic. Differentials include malaria, tuberculosis, typhoid fever, kala-azar, prolonged Salmonella bacteraemia, lymphoma, toxocariasis, liver abscesses and fever of undetermined origin. For symptomatic hospitalised patients, treatment with steroids and schistosomicides is recommended. Treatment is curative in those timely diagnosed.
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Clerinx J, Van Gompel A. Schistosomiasis in travellers and migrants. Travel Med Infect Dis 2011; 9:6-24. [DOI: 10.1016/j.tmaid.2010.11.002] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2010] [Revised: 11/09/2010] [Accepted: 11/18/2010] [Indexed: 02/07/2023]
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McManus DP, Gray DJ, Li Y, Feng Z, Williams GM, Stewart D, Rey-Ladino J, Ross AG. Schistosomiasis in the People's Republic of China: the era of the Three Gorges Dam. Clin Microbiol Rev 2010; 23:442-66. [PMID: 20375361 DOI: 10.1128/CMR.00044-09] [Citation(s) in RCA: 166] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The potential impact of the Three Gorges Dam (TGD) on schistosomiasis transmission in China has invoked considerable global concern. The TGD will result in changes in the water level and silt deposition downstream, favoring the reproduction of Oncomelania snails. Combined with blockages of the Yangtze River's tributaries, these changes will increase the schistosomiasis transmission season within the marshlands along the middle and lower reaches of the Yangtze River. The changing schistosome transmission dynamics necessitate a comprehensive strategy to control schistosomiasis. This review discusses aspects of the epidemiology and transmission of Schistosoma japonicum in China and considers the pathology, clinical outcomes, diagnosis, treatment, immunobiology, and genetics of schistosomiasis japonica together with an overview of current progress in vaccine development, all of which will have an impact on future control efforts. The use of synchronous praziquantel (PZQ) chemotherapy for humans and domestic animals is only temporarily effective, as schistosome reinfection occurs rapidly. Drug delivery requires a substantial infrastructure to regularly cover all parts of an area of endemicity. This makes chemotherapy expensive and, as compliance is often low, a less than satisfactory control option. There is increasing disquiet about the possibility that PZQ-resistant schistosomes will develop. Consequently, as mathematical modeling predicts, vaccine strategies represent an essential component in the future control of schistosomiasis in China. With the inclusion of focal mollusciciding, improvements in sanitation, and health education into the control scenario, China's target of reducing the level of schistosome infection to less than 1% by 2015 may be achievable.
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Abstract
Katayama syndrome is an early clinical manifestation of schistosomiasis that occurs several weeks post-infection with Schistosoma spp (trematode) worms. Because of this temporal delay and its non-specific presentation, it is the form of schistosomiasis most likely to be misdiagnosed by travel medicine physicians and infectious disease specialists in non-endemic countries. Katayama syndrome appears between 14-84 days after non-immune individuals are exposed to first schistosome infection or heavy reinfection. Disease onset appears to be related to migrating schistosomula and egg deposition with individuals typically presenting with nocturnal fever, cough, myalgia, headache, and abdominal tenderness. Serum antibodies and schistosome egg excretion often substantiate infection if detected. Diffuse pulmonary infiltrates are found radiologically, and almost all cases have eosinophilia and a history of water contact 14-84 days before presentation of clinical symptoms; patients respond well to regimens of praziquantel with and without steroids. Artemisinin treatment given early after exposure may decrease the risk of the syndrome.
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Affiliation(s)
- Allen G Ross
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Canada.
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12
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Abstract
Schistosomiasis or bilharzia is a tropical disease caused by worms of the genus Schistosoma. The transmission cycle requires contamination of surface water by excreta, specific freshwater snails as intermediate hosts, and human water contact. The main disease-causing species are S haematobium, S mansoni, and S japonicum. According to WHO, 200 million people are infected worldwide, leading to the loss of 1.53 million disability-adjusted life years, although these figures need revision. Schistosomiasis is characterised by focal epidemiology and overdispersed population distribution, with higher infection rates in children than in adults. Complex immune mechanisms lead to the slow acquisition of immune resistance, though innate factors also play a part. Acute schistosomiasis, a feverish syndrome, is mostly seen in travellers after primary infection. Chronic schistosomal disease affects mainly individuals with long-standing infections in poor rural areas. Immunopathological reactions against schistosome eggs trapped in the tissues lead to inflammatory and obstructive disease in the urinary system (S haematobium) or intestinal disease, hepatosplenic inflammation, and liver fibrosis (S mansoni, S japonicum). The diagnostic standard is microscopic demonstration of eggs in the excreta. Praziquantel is the drug treatment of choice. Vaccines are not yet available. Great advances have been made in the control of the disease through population-based chemotherapy but these required political commitment and strong health systems.
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Affiliation(s)
- Bruno Gryseels
- Institute for Tropical Medicine Antwerp, Nationalestraat 155 B-2000, Antwerp, Belgium.
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Sersar SI, Elnahas HA, Saleh ABM, Moussa SA, Ghafar WAA. Pulmonary parasitosis: applied clinical and therapeutic issues. Heart Lung Circ 2005; 15:24-9. [PMID: 16473787 DOI: 10.1016/j.hlc.2005.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2004] [Revised: 03/24/2005] [Accepted: 04/04/2005] [Indexed: 01/02/2023]
Abstract
BACKGROUND The aim of this study is to review the problems encountered in treating pulmonary hydatid and bilharsiasis and to highlight the risks associated with chemotherapy and the delay of their surgical treatment. METHODS The medical records of 60 patients with pulmonary hydatid and bilharsiasis were retrospectively investigated. The patients were divided into two groups based on whether the parasite was hydatid (group 1, n=56) or schistosomiasis (group 2, n=4). The group 1 was divided into group 1a (complicated cyst n=32) and group 1b (n=24 noncomplicated hydatids). RESULTS In all cases of pulmonary bilharsiasis and intact pulmonary hydatid cysts, the lesions were either incidental findings or the patient had presented with haemoptysis, cough, dyspnea and chest pain. The differences between the groups with respect to the rates of preoperative complications and postoperative morbidity, frequency of decortication and hospital stay were statistically insignificant (p>0.05). CONCLUSIONS Complicated cases have higher rates of preoperative and postoperative complications but the differences are insignificant. Complicated cases are easier to diagnose. This underlines the need for paying more attention to the possibility of pulmonary parasitosis especially in lower lobe lesions in endemic areas.
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Affiliation(s)
- Sameh Ibrahim Sersar
- Cardiothoracic Surgery Department, Mansoura University, Mansoura, Dakahlia 35516, Egypt.
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Waldman AD, Day JH, Shaw P, Bryceson AD. Subacute pulmonary granulomatous schistosomiasis: high resolution CT appearances--another cause of the halo sign. Br J Radiol 2001; 74:1052-5. [PMID: 11709472 DOI: 10.1259/bjr.74.887.741052] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
A case of probable acute granulomatous pulmonary schistosomiasis is described with multiple focal opacities on chest radiography and widespread, but predominantly peribronchovascular, nodules with ground-glass halos on high resolution CT (HRCT). The HRCT appearances in early schistosomiasis have not been described previously. Although the features are not diagnostic and may be seen in other conditions, in the appropriate clinical context they may suggest pulmonary involvement in schistosomiasis. The features of pulmonary schistosomiasis in the different stages of infection are discussed. Pulmonary involvement should be suspected in patients with even minor respiratory symptoms when there is a history of exposure to fresh water in endemic areas.
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Affiliation(s)
- A D Waldman
- Lysholm Department of Radiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
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