Schistosomes - Symptoms And Treatment Of Genitourinary Hematobium

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Schistosomes - Symptoms And Treatment Of Genitourinary Hematobium
Schistosomes - Symptoms And Treatment Of Genitourinary Hematobium

Video: Schistosomes - Symptoms And Treatment Of Genitourinary Hematobium

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Video: Schistosomiasis | Bilharziasis | Causes, Symptoms and Treatment 2023, February
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  • 1 What is schistosomiasis?
  • 2 Life cycle and forms
  • 3 Symptoms
  • 4 Treatment of schistosomiasis

A chronic helminthic disease that is provoked by trematodes is called schistosomiasis or bilharziasis. The intestines and / or the genitourinary system are most commonly affected. Timely treatment for schistosomiasis is essential, as it can lead to developmental delays in children, anemia, and even death. With timely treatment, the dangerous consequences of the disease are reversible. There are two forms of this disease - intestinal and genitourinary schistosomiasis.

What is schistosomiasis?

genitourinary schistosomiasis
genitourinary schistosomiasis

Genitourinary schistosomiasis provokes the helminth Schistosoma haematobium, and the parasite Schistosoma mansoni is responsible for the development of the intestinal form of the disease. There is also Japanese schistosomiasis, which develops against the background of the invasion of Schistosoma japonicum. The most common genitourinary schistosomiasis, also called bilharziasis.

The structure of the schistosome is as follows: their symmetrical body has lateral and oral suckers, and the body is covered with syncytial epithelium from above. The digestive system consists of the esophagus and mouth. Adults are dioecious. Their length reaches 2 cm and their width is up to 0.6 cm.

People involved in fishing and agriculture are most likely to contract schistosomiasis. Women who use contaminated water for domestic purposes are also at risk of infection. Since the mode of infection is usually associated with poor hygiene, it is quite common for children to get sick.

Schistosoma hematobium and Japanese schistosoma quite often amaze ecotourists who prefer to visit “uninhabited places”. Sometimes schistosomiasis in humans manifests itself in a particularly severe acute form, which is accompanied by paralysis. Urogenital schistosomiasis is commonly found in America (South and Central), Africa, and Japanese schistosomiasis occurs in Asia (south and east) and Japan.

Life cycle and forms

life cycle of schistosoma
life cycle of schistosoma

What is schistosomiasis, we figured it out, now we will consider the forms of this disease and the life cycle of the parasite. As for the main routes of infection, they are due to contact with infected water. Blood schistosome, namely the larva of the parasite, is secreted by freshwater gastropods and enters the human body through the skin.

The life cycle of a schistosoma is as follows:

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  1. Helminth eggs develop in freshwater molluscs until they reach the cercaria stage. It is they that are introduced into the human body through the skin.
  2. Here the parasite matures rather quickly, reaching the schistosomula stage. These individuals can penetrate the peripheral veins, where they develop to the stage of sexually mature individuals.
  3. After fertilization of females, they are sent to their permanent habitat, namely to the pelvic, hemorrhoidal and mesenteric veins. They also penetrate the walls of the large intestine.
  4. This is where females lay their eggs, causing tissue damage. Some eggs, together with feces and urine, are excreted into the external environment, acting as a source of infection.

The parasite lives in the human body for up to two years, but if a chronic course of schistosomiasis is observed, then the helminth can live in the host's body for up to thirty years.

There are two forms of the disease:

  1. Genitourinary schistosomiasis;
  2. Intestinal schistosomiasis.

Symptoms and treatment may differ depending on the form of schistosomiasis. So, genitourinary schistosomiasis is usually manifested by a complex of symptoms from the urinary and reproductive system, and the intestinal form is characterized by the presence of symptoms from the digestive tract.

Symptoms

itching of the skin
itching of the skin

The appearance of signs of schistosomiasis is caused by the response of the human body to the presence of eggs of the parasite, and not sexually mature worms. The first symptoms of schistosomiasis appear as:

  • papular rashes;
  • itching of the skin;
  • local erythema.

During the period of migration of schistosomules in the human body (especially through the lungs), symptoms can be supplemented by a cough with discharge of thick sputum, enlargement of the spleen, liver and lymph nodes.

For the period of puberty of the parasite and the beginning of laying eggs, the appearance of chronic inflammatory processes in the body is characteristic. For the late stage of the disease, the following symptoms are characteristic:

  • pulmonary and hepatic vein embolism;
  • chronic colitis;
  • myocarditis;
  • obliterating endarteritis;
  • pseudo-elephantiasis of the genitals.

The acute form of the disease begins 6-8 days after infection. In the place of penetration of the parasite, an allergic focus is formed in the form of urticaria. General malaise, fever, chills, headache, pain in muscle tissues and joints appear. In the KLA, eosinophilia, leukocytosis, increased ESR.

Genitourinary schistosomiasis differs in clinical manifestations from the intestinal form:

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The intestinal variety of the disease is characterized by the presence of such symptoms:

  • diarrhea;
  • pain in the abdomen;
  • blood in the feces;
  • enlargement of the spleen and liver is present in advanced cases.

Urogenital schistosoma makes itself felt after 4-6 months from the moment of infection. Usually schistosis of the bladder is manifested by hematuria. In advanced cases, fibrosis of the ureters, bladder and kidney damage develops. If a secondary infection joins, frequent painful urination is observed. If there is a blockage of the ureter with mucopurulent discharge and blood clots, then aching pains in the lower back join. Also attacks of renal colic are possible

Sometimes the disease is asymptomatic and is accidentally discovered during examination for another reason. But more often patients are worried about headache, fatigue, loss of appetite, weakness, sleep disturbance. It is believed that the genitourinary form of the disease increases the risk of HIV infection.

Treatment of schistosomiasis

schistosomiasis treatment
schistosomiasis treatment

If schistosomiasis is suspected, treatment is carried out after careful diagnosis. To confirm the diagnosis, it is sufficient to detect the eggs of the parasite in urine or feces samples. To date, a WHO strategy against schistosomiasis has been developed. For this purpose, all people at risk are treated with Praziquantel:

  • schoolchildren in regions endemic for schistosomiasis;
  • breastfeeding mothers and pregnant women;
  • fishermen, farmers, agricultural workers and all those who come into contact with contaminated water;
  • communities living in endemic regions.

If we talk about how to treat schistosomiasis, then an effective and safe therapy is carried out using Praziquantel. For children, the drug is prescribed on the basis of weight - 50 mg of the drug for each kg of weight.

This drug is allowed to be combined with Albendazole, which is used to treat intestinal helminthiasis caused by whipworm, hookworms and roundworms. Since re-infection is possible, the course of therapy must be repeated after a year.

Treatment should be postponed for a while in such cases:

  • due to the child's discomfort;
  • in the first trimester of pregnancy;
  • with chronic blood ailments (sickle cell anemia);
  • do not treat children under one year old.

Praziquantel therapy usually does not produce adverse reactions. Undesirable effects can occur with severe types of helminthiasis. In this case, headache, vomiting, nausea, diarrhea, pain in the stomach, fever may appear.

Prevention of schistosomiasis consists in health education of the population, improvement of sanitary living conditions. Also for this purpose, they fight against gastropods. Part of preventive measures is compulsory preventive treatment of the population at risk.

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