Smarter Decisions,
Better Care

UpToDate synthesizes the most recent medical information into evidence-based practical recommendations clinicians trust to make the right point-of-care decisions.

  • Rigorous editorial process: Evidence-based treatment recommendations
  • World-Renowned physician authors: over 5,100 physician authors and editors around the globe
  • Innovative technology: integrates into the workflow; access from EMRs

Choose from the list below to learn more about subscriptions for a:


Subscribers log in here


Diagnosis of schistosomiasis

INTRODUCTION

Schistosomiasis is caused by infection with Schistosoma haematobium, S. mansoni, S. japonicum, S. mekongi, or S. intercalatum. The various species are associated with different clinical complications. The clinical features also differ in acute and chronic infections.

The diagnosis of schistosomiasis will be reviewed here. The epidemiology, pathogenesis, clinical features, treatment, and prevention of these infections are discussed separately. (See "Epidemiology, pathogenesis, and clinical features of schistosomiasis" and "Treatment and prevention of schistosomiasis".)

DIAGNOSIS

Many people who are infected with schistosomiasis are asymptomatic and only investigated because infection is suspected on the basis of epidemiologic history (eg, travelers). (See "Epidemiology, pathogenesis, and clinical features of schistosomiasis".)

Routine blood or urine tests may show nonspecific abnormalities. The diagnosis of schistosomiasis can be confirmed by microscopy with egg identification, by serology, or by consistent radiologic findings in the appropriate clinical scenario. A diagnosis of schistosomiasis should prompt initiation of treatment, even if the patient is asymptomatic, since adult worms can live for years [1]. (See "Treatment and prevention of schistosomiasis".)

Nonspecific laboratory abnormalities — A routine full blood count may show eosinophilia in infected patients [2]. The degree of eosinophilia relates to the stage, intensity, and duration of infection, as well as to genetic determinants of the host [3]. Most studies suggest between one- and two-thirds of infected patients have a peripheral eosinophilia, which is frequently most marked early in the course of infection. Eosinophilia is also a frequent finding in patients with Katayama fever, a hypersensitivity reaction seen with acute infection [4]. (See "Epidemiology, pathogenesis, and clinical features of schistosomiasis".)

               

Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: Aug 2014. | This topic last updated: Dec 7, 2007.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2014 UpToDate, Inc.
References
Top
  1. Warren KS, Mahmoud AA, Cummings P, et al. Schistosomiasis mansoni in Yemeni in California: duration of infection, presence of disease, therapeutic management. Am J Trop Med Hyg 1974; 23:902.
  2. Pardo J, Carranza C, Muro A, et al. Helminth-related Eosinophilia in African immigrants, Gran Canaria. Emerg Infect Dis 2006; 12:1587.
  3. Mahmoud AA. The ecology of eosinophils in schistosomiasis. J Infect Dis 1982; 145:613.
  4. Gundersen SG, Ravn J, Haagensen I. Early detection of circulating anodic antigen (CAA) in a case of acute schistosomiasis mansoni with Katayama fever. Scand J Infect Dis 1992; 24:549.
  5. Nduka FO, Ajaero CM, Nwoke BE. Urinary schistosomiasis among school children in an endemic community in south-eastern Nigeria. Appl Parasitol 1995; 36:34.
  6. Amali O. Estimation of prevalences of urinary schistosomiasis using haematuria. Cent Afr J Med 1994; 40:152.
  7. Nwaorgu OC, Anigbo EU. The diagnostic value of haematuria and proteinuria in Schistosoma haematobium infection in southern Nigeria. J Helminthol 1992; 66:177.
  8. Taylor P, Chandiwana SK, Matanhire D. Evaluation of the reagent strip test for haematuria in the control of Schistosoma haematobium infection in schoolchildren. Acta Trop 1990; 47:91.
  9. Sarda RK, Minjas JN, Mahikwano LF. Evaluation of indirect screening techniques for the detection of Schistosoma haematobium infection in an urban area, Dar es Salaam, Tanzania. Acta Trop 1985; 42:241.
  10. Stephenson LS, Latham MC, Kinoti SN, Oduori ML. Sensitivity and specificity of reagent strips in screening of Kenyan children for Schistosoma haematobium infection. Am J Trop Med Hyg 1984; 33:862.
  11. Harries AD, Fryatt R, Walker J, et al. Schistosomiasis in expatriates returning to Britain from the tropics: a controlled study. Lancet 1986; 1:86.
  12. Peters, P, Kazura, JW. Update on diagnostic methods for schistomiasis. Baillere's Clinical Tropical Medicine and Communicable Diseases 1987; 2:419.
  13. Elliott DE. Schistosomiasis. Pathophysiology, diagnosis, and treatment. Gastroenterol Clin North Am 1996; 25:599.
  14. King, C, Mahmouud, AA. Schistosomiasis. In: Tropical Infectious Diseases: Principles, Pathogens and Practice, Vol 2, Guerrant, R, Walker, DH, Weller, PF, (Eds), Churchill Livingstone, Philadelphia 1999. p.1031.
  15. Lucey DR, Maguire JH. Schistosomiasis. Infect Dis Clin North Am 1993; 7:635.
  16. Shimazu C, Pien FD, Parnell D. Bronchoscopic diagnosis of Schistosoma japonicum in a patient with hemoptysis. Respir Med 1991; 85:331.
  17. Schaberg T, Rahn W, Racz P, Lode H. Pulmonary schistosomiasis resembling acute pulmonary tuberculosis. Eur Respir J 1991; 4:1023.
  18. Ferrari TC. Spinal cord schistosomiasis. A report of 2 cases and review emphasizing clinical aspects. Medicine (Baltimore) 1999; 78:176.
  19. Rabello AL, Garcia MM, Pinto da Silva RA, et al. Humoral immune responses in patients with acute Schistosoma mansoni infection who were followed up for two years after treatment. Clin Infect Dis 1997; 24:304.
  20. Deelder AM, Qian ZL, Kremsner PG, et al. Quantitative diagnosis of Schistosoma infections by measurement of circulating antigens in serum and urine. Trop Geogr Med 1994; 46:233.
  21. Van Lieshout L, Panday UG, De Jonge N, et al. Immunodiagnosis of schistosomiasis mansoni in a low endemic area in Surinam by determination of the circulating antigens CAA and CCA. Acta Trop 1995; 59:19.
  22. de Jonge N, Kremsner PG, Krijger FW, et al. Detection of the schistosome circulating cathodic antigen by enzyme immunoassay using biotinylated monoclonal antibodies. Trans R Soc Trop Med Hyg 1990; 84:815.
  23. Van 't Wout AB, De Jonge N, Tiu WU, et al. Schistosome circulating anodic antigen in serum of individuals infected with Schistosoma japonicum from the Philippines before and after chemotherapy with praziquantel. Trans R Soc Trop Med Hyg 1992; 86:410.
  24. Hassan MM, Medhat A, Makhlouf MM, et al. Detection of circulating antigens in patients with active Schistosoma haematobium infection. Am J Trop Med Hyg 1998; 59:295.
  25. Salah F, El Bassiouny A, Rabia I, et al. Human schistosomiasis haematobium: effective diagnosis of active infection using a pair of monoclonal antibodies against soluble egg antigen. Parasitol Res 2006; 99:528.
  26. de Jonge N, De Caluwé P, Hilberath GW, et al. Circulating anodic antigen levels in serum before and after chemotherapy with praziquantel in schistosomiasis mansoni. Trans R Soc Trop Med Hyg 1989; 83:368.
  27. van Lieshout L, Polderman AM, Deelder AM. Immunodiagnosis of schistosomiasis by determination of the circulating antigens CAA and CCA, in particular in individuals with recent or light infections. Acta Trop 2000; 77:69.
  28. Sandoval N, Siles-Lucas M, Pérez-Arellano JL, et al. A new PCR-based approach for the specific amplification of DNA from different Schistosoma species applicable to human urine samples. Parasitology 2006; 133:581.
  29. Richter J, Hatz C, Häussinger D. Ultrasound in tropical and parasitic diseases. Lancet 2003; 362:900.
  30. Abdel-Wahab MF, Esmat G, Farrag A, et al. Grading of hepatic schistosomiasis by the use of ultrasonography. Am J Trop Med Hyg 1992; 46:403.
  31. Yazdanpanah Y, Thomas AK, Kardorff R, et al. Organometric investigations of the spleen and liver by ultrasound in Schistosoma mansoni endemic and nonendemic villages in Senegal. Am J Trop Med Hyg 1997; 57:245.
  32. Bezerra AS, D'Ippolito G, Caldana RP, et al. Chronic hepatosplenic schistosomiasis mansoni: magnetic resonance imaging and magnetic resonance angiography findings. Acta Radiol 2007; 48:125.