Schistosomiasis

Question 1

Complications

Answer 1

Bladder: secondary bact infection, bladder wall calcifications, baller calculi, small bladder capacity, squamous metaplasia➡️ squamous ca.

Ureter: atony, VUR, ureteric stricture, renal fail

Question 2

Clinical presentation

Answer 2

Cercarial dermatitis= swimmers itch
Katayama fever( only in non endemic pops, allergic rxn in liver, fever jaundice and HSM)
Urinary schistosomiasis terminal haematuria, dysuria and frequency)

Question 3

Diagnosis

NB‼️ needs a high index of suspicion

Answer 3

Urine: terminal urine, midday & post exercise on micro terminal spike
FBC eosinophilia
Serology Elisa but doesn’t say when.
IVP/ EUG: calcifications, dilated ureters, filling defect in bladder and small capacity bladder.
Cystoscopy

Question 4

Treatment

Answer 4

Prophylaxis: housing and sanitation, snail eradication, prophyl medical mx.
Medical: praziquantel
Surgical: for complications

Question 5

Life cycle

Answer 5

Excreted into water➡️ viable in three weeks➡️ hatch & form miracidia➡️ enter Bulinis snail & form sporocysts in liver➡️ release circariae into water➡️ penetrate skin of human➡️ reach hepatic views & mature and mate➡️ females lay eggs in bladder mucosa and ureters via pelvic veins➡️ urinated back into water