Schistosomiasis

Posted by e-Medical PPT Sunday, September 9, 2012
Introduction
Schitosoma japonicum inhabits in the portal 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

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

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)

Pathology
Colon: acute -mucosa congestion,
                  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

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
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..
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