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Schistosomiasis: diagnosis
Last reviewed: 23.04.2024
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In the acute period of the disease, the diagnosis of schistosomiasis takes into account the epidemiological anamnesis, the presence of signs of "cercaria dermatitis" after bathing in the infected reservoirs.
Urine test is performed after centrifugation, and it should be borne in mind that the maximum number of eggs is excreted in the urine between 10 and 14 hours of the day. The invasion is assessed as intensive with the number of eggs of S. Haematobium more than 50 in 10 ml of urine and more than 100 eggs of S. Mansoni, S. Japonicum, S. Intercalatum and S. Mekongi in 1 g of feces. Eggs of schistosomes in faeces are detected using various methods of coprocopy: research of the native smear (ineffective), deposition after breeding of feces, preparation of smears by Kato-Katz, etc. Analyzes must be repeated many times, especially in cases of chronic course and development of fibrous changes in the intestine.
Cystoscopy makes it possible to identify specific changes in urogenital schistosomiasis on the mucous membrane of the bladder: granulomas, "sand spots", black microgranulation, infiltrates. A valuable addition to cystoscopy is the endobiopsy. In contrast urography, changes in the structure of the ureters are observed. X-ray examination allows detecting changes in the lungs, calcification of the walls of the bladder. For the detection of organ and functional disorders, also use fibrocolonoscopy (with endobiosis), ultrasound of the abdominal cavity and small pelvis, etc.
[Indications for consultation of other specialists
Diagnosis of schistosomiasis is complemented by consultations of the proctologist with a complicated course of intestinal schistosomiasis; urologist with complicated course of urogenital schistosomiasis; hepatologist - with liver damage: a cardiologist - in the presence of signs of a "pulmonary" heart.
Differential diagnosis of schistosomiasis
Differential diagnosis of schistosomiasis is carried out with acute intestinal infectious diseases, typhoid paratyphoid diseases, visceral leishmaniasis, with serum sickness, and with severe eosinophilia - with the migratory phase of other helminthiases (strongyloidiasis, filariasis, etc.). Intestinal forms of schistosomiasis must be differentiated from amebiasis, shigellosis, chronic colitis, cirrhosis of the virus and other nature; genitourinary schistosomiasis - from various diseases of the genitourinary system, including inflammatory diseases, tuberculosis and cancer of the urinary tract. However, the diagnosis becomes easy after the appearance of eggs in the urine (S. Haematobium) and feces (S. mansoni, S. Japonicum, S. Mekongi, S. Intercalatum).