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    Schistoma

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    Schistosomiasis is caused by a parasitic flatworm called Schistosoma that lives in veins around the bladder and intestines. It is transmitted through skin contact with water contaminated with the parasite's larval form. The parasite's eggs cause immune reactions that result in liver and intestinal damage over time. Symptoms range from fever and rashes during initial infection to long-term issues like liver damage and portal hypertension. Diagnosis involves finding eggs in stool or biopsy samples, and treatment primarily uses the drug praziquantel. Prevention focuses on sanitation, snail control, and avoiding contaminated water contact.

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    Schistoma

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    Bio Sciences
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    Schistosomiasis is caused by a parasitic flatworm called Schistosoma that lives in veins around the bladder and intestines. It is transmitted through skin contact with water contaminated with the parasite's larval form. The parasite's eggs cause immune reactions that result in liver and intestinal damage over time. Symptoms range from fever and rashes during initial infection to long-term issues like liver damage and portal hypertension. Diagnosis involves finding eggs in stool or biopsy samples, and treatment primarily uses the drug praziquantel. Prevention focuses on sanitation, snail control, and avoiding contaminated water contact.

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    Schistosomiasis is caused by a parasitic flatworm called Schistosoma that lives in veins around the bladder and intestines. It is transmitted through skin contact with water contaminated with the parasite's larval form. The parasite's eggs cause immune reactions that result in liver and intestinal damage over time. Symptoms range from fever and rashes during initial infection to long-term issues like liver damage and portal hypertension. Diagnosis involves finding eggs in stool or biopsy samples, and treatment primarily uses the drug praziquantel. Prevention focuses on sanitation, snail control, and avoiding contaminated water contact.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    17 views33 pages

    Schistoma

    Uploaded by

    Bio Sciences
    Schistosomiasis is caused by a parasitic flatworm called Schistosoma that lives in veins around the bladder and intestines. It is transmitted through skin contact with water contaminated with the parasite's larval form. The parasite's eggs cause immune reactions that result in liver and intestinal damage over time. Symptoms range from fever and rashes during initial infection to long-term issues like liver damage and portal hypertension. Diagnosis involves finding eggs in stool or biopsy samples, and treatment primarily uses the drug praziquantel. Prevention focuses on sanitation, snail control, and avoiding contaminated water contact.

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    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 33

    Schistosomiasis

    Schitosoma japonicum inhabits in the portal

    Introduction

    venous system Skin contact with water contaminated by cercaria The basic pathologic lesion is the egg granuloma in the liver and colon Acute schitosomiasis:fever,enlargement and tenderness of the liver,eosinophilia,and dysentery Chronic schitosomiasis : fibro-obstructive lesion around the portal vessels Late stage: giant spleen, ascites, hypertension of portal venous system

    Etiology
    Mature worms: Dioecious
    Female :long and thin. Male:short and thick

    Eggs: miracidia in it

    Life cycle
    adult worm passing eggs
    egg into fresh water

    cercariae
    miracidia

    penetrate into the body of the snail (intermediate host) oncomelania

    Life Cycle of Schistosoma spp.

    78

    2530

    Epidemiology
    Source of infection: humans and mammals

    (especially cattle) infected by schistosome Route of transmission: three major factors* are responsible for the occurrence of schistosomiasis Susceptibility : everyone is susceptive. Especially peasant and fisherman

    Three Major Factors


    The method of disposal of human

    excreta The presence of the snail intermediate host The contact with cercaria-infected water

    Pathogenesis
    It belong to a kind of allergic

    reaction(rapid & delayed) Formation of granuloma produced by eggs (Hoeplli sign) Concomitant immunity Ectopic lesion (lung & brain)

    Colon: acute -mucosa congestion,

    Pathology

    edema and egg granuloma chronic-fibro obstructive lesion Liver: acute -enlargement of the liver and egg granuloma on it chronic-portal liver cirrhosis Other organs: lung and brain, etc Systemic symptoms:

    Clinical Manifestations

    Acute Schistosomiasis
    Mainly occurs during July to September The history of contact with schistosome-

    infected water. Schistosome dermatitis Incubation period: 23-73 days, average 1 month

    Acute Schistosomiasis
    Clinical manifestations come out after 4 to 8

    weeks of infection, similar to the time from egg to adult worm (40 days) Fever: intermittent, maintain weeks to months Allergic reaction:urticaria, angioneuroedema, enlargement of lymph nodes and eosinophilia Digestive syndromes: abdominal pain, diarrhea with pus and blood, constipation or diarrhea Hepatosplenomegaly

    Chronic Schistosomiasis
    Asymptomatic: most person are

    asymptomatic Symptomatic: the most common syndrome is abdominal pain with intermittent diarrhea. hepatosplenomegaly

    Terminal stage of schistosomiasis


    Liver cirrhosis is the prominent syndrome

    of this stage According to the manifestations , it can be divided into three types: The type of giant spleen The type of ascites The type of dwarf

    Ectopic Lesion
    Schistosomiasis in lungs:

    found in acute schistosomiasis, by egg deposition. Symptoms are light and signs are not clear Schistosomiasis in brain: Acute type: encephalomeningitis Chronic type: focal epilepsy

    Laboratory Findings

    Blood Routine Test


    Acute stage :eosinophilia is characteristic

    change.WBC raise to 10-30G/L Chronic stage:eosinophil slightly or moderate rise Terminal stage: WBC and platelets are lower

    Liver Function Test


    Acute stage: serum globulin rise, ALT

    slightly rise Chronic stage: most patients have a normal liver function, especially asymptomatic Terminal stage: serum ALB descend caused by liver cirrhosis

    Stool Test
    The discovery of eggs in stool is the evidence of

    diagnosis by direct smear or other methods

    Imaging test
    B-ultrasound: the degree of liver cirrhosis CT: the image of liver and brain X-ray: chest; esophagus; and gastrointestinal

    tract

    Biopsy by Rectal Endoscope Immunological Test


    Intracutaneous test Circumoval precipition test ELISA and IHA etc.

    Monoclonal antibody technique

    Complications

    Complications of Liver Cirrhosis


    Varicosity of esophagus-fundus-stomach

    Hemorrhage of upper gastrointestinal tract


    Hepatic encephalopathy (HE) Spontaneous bacteria peritonitis (SBP)

    Complications of intestinal tract


    Appendicitis

    Intestinal obstruction and cancroid change

    Diagnosis
    Epidemiologic date: occupation, history of

    travel to endemic area, contact with infected water Clinical date: Acute stage; chronic stage; terminal stage Laboratory findings: Blood Rt; characteristic eggs in feces; biopsy; positive immunological test

    Differential Diagnosis
    Acute schistosomiasis: typhoid fever; amebic

    liver abscess; tubercular peritonitis; miliary tuberculosis; bacillary dysentery; malaria;etc. etiology test and X-ray of chest are diagnostic. Chronic schistosomiasis:anicteric viral hepatitis;amebic dysentery; chronic bacillary dysentery; Terminal schistosomiasis: portal liver cirrhosis and necrosis liver cirrhosis

    Prognosis
    Factors affect the prognosis:

    The continuance of infection The last of pathogenesis The age of the patients The complications

    Treatment

    Pathogenic Treatment
    Praziquantel is the best choice of drug for the

    therapy of schistosomiasis Dose: chronic schistosomiasis 10mg/kg, tid. Po, for 2 days, total 60mg/kg Acute schistosomiasis 10mg/kg,tid. po,for 4 days, total 120mg/kg Vice reaction: slight and short.

    Heteropathy
    Acute schistosomiasis: rest, nutrition, and

    supportive theraphy. Cortical hormone can be used in minidose for severe toxic symptoms. Terminal schistosomiasis: treated as liver cirrhosis, and treat for complications

    Prevention
    Control of the source of infection:

    Treat the patients and domestic animal at the same time. Cut off the route of transmission: Snail control Sanitary disposal of human excreta Protect of susceptive people:avoid the contact with schistosome-infected water

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