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Schistosomiasis: symptoms
Last reviewed: 23.04.2024
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[Symptoms of schistosomiasis of the genitourinary
Schistosomiasis of the urogenital is caused by Schistosoma haematobium. The male has dimensions of 12-14 x 1 mm, the female - 18-20 x 0.25 mm. Eggs elongated, oval, with a spine on one pole. The size of eggs is 120-160 x 40-60 microns. The female lays eggs in small vessels of the bladder and genital organs.
In the clinical course, three stages are distinguished: acute, chronic and stage of outcome.
Symptoms of schistosomiasis of the genitourinary, associated with the introduction of cercariae, in the form of allergic dermatitis in nonimmune individuals are rarely recorded. After 3-12 weeks of a latent period, acute schistosomiasis may develop. There are headaches, weakness, common soreness in the back and limbs, lack of appetite, body temperature rises, especially in the evening, often with chills and strong sweat, observe urticaria rash (unstable); characterized by hypereosinophilia (up to 50% and higher). The liver and spleen are often enlarged. Identify violations of the cardiovascular system and respiratory organs.
The earliest symptoms of schistosomiasis of the genitourinary chronic are haematuria, which is often terminal (at the end of urination, drops of blood appear in the urine). Mark the pain in the suprapubic region and perineum. These symptoms of schistosomiasis of the urino-genital are caused by the reaction of the tissues of the bladder and genital organs to the introduction of eggs with schistosomes. In later stages, cystitis caused by a secondary infection may join. Cystoscopy on the mucosa of the bladder reveals tubercles (histologically - a conglomerate of specific granules) - whitish yellow formations with the size of a pinhead, as well as infiltrates, papillomatous growths, erosions, ulcers, "sand spots" - translucent clusters of calcified eggs radiating through a thin mucous membrane schistosomes. Stenosis of the ureters and fibrosis of the neck of the bladder creates conditions for stagnation of urine, the formation of concrements, and subsequently - hydronephrosis and pyelonephritis. There are also lesions of the genital organs: in men - fibrosis of spermatic cord, orchitis, prostatitis, in women - the formation of papillomas and ulceration of the mucous membranes of the vagina and cervix. In the late period, the formation of fistulas of the urinary bladder, neoplasms of the genitourinary system. The defeat of the lungs and their vessels leads to hypertension in a small circle of blood circulation: the patients have shortness of breath, a feeling of palpitations, signs of hypertrophy of the right ventricle of the heart.
Symptoms of schistosomiasis of the intestinal
Schistosomiasis of the intestinal is caused by S. Mansoni. The male has dimensions of 10-12 x 1.2 mm, the female - 12-16 x 0.17 mm. Eggs (130-180 x 60-80 microns) are somewhat elongated, on the side surface of the shell, closer to one pole, there is a large spine bent to the pole.
Soon after infection, it is also possible to develop dermatitis, followed by fever, weakness, headache. These symptoms of intestinal schistosomiasis last from 1 to 7-10 days.
Acute intestinal schistosomiasis is characterized by fever (remitting, intermittent, irregular), impaired appetite, nausea, vomiting, frequent loose stools, sometimes with dehydration; possible admixture of blood in the feces, abdominal pains, in some cases resembling a picture of "acute abdomen", cough with phlegm, often tachycardia, arterial hypotension. They note weakness, adynamy, less often excitation. In the blood - hypereosinophilia, leukocytosis. Sometimes hepatitis develops. Symptoms of schistosomiasis of the intestinal acute are observed during the first 3 months after infection.
In the chronic period of the disease, the main symptoms of schistosomiasis of the intestinal are associated with the defeat of the colon, especially the distal parts of it. There is bowel dysfunction in the form of a loose stool, alternating of a loose stool and constipation or chronic constipation. Note the aching pain in the course of the colon. With exacerbations, a dysentery-like syndrome develops: the chair is more frequent, mucus-bloody: cramping pains in the abdomen, tenesmus, fever, as a rule, is absent. The subsiding exacerbation is replaced by constipation; often formed cracks in the anus, hemorrhoids. At a colonoscopy mainly in its distal departments the hyperemia, puffiness of a mucosa, multiple dot hemorrhages are registered; sometimes there is polyposis of the intestine, infiltrates in the intestinal wall resembling a tumor.
In schistosomiasis lesions of the liver (hepatosplenomegalic form), the outcome of the process is periportal fibrosis and cirrhosis of the liver. Regardless of intestinal symptoms, patients note the appearance of a "tumor" in the upper half of the abdomen. Pains insignificant, disturbs feeling of gravity, discomfort. The liver is enlarged, dense, its surface is tuberous. Biochemical indicators do not undergo significant changes until signs of decompensation of liver function appear. With the development of portal hypertension, the veins of the esophagus and stomach expand, and as a result of their rupture, bleeding may occur. Decompensation of portal blood circulation is manifested by ascites. The spleen is also enlarged. When S. Mansoni is invaded , glomerulonephritis is recorded, which is caused by the formation and deposition of immune complexes.
The defeat of the lungs, if blood circulation is not disturbed in them, does not give noticeable clinical manifestations. If the pressure in the pulmonary artery exceeds 60 mm Hg. The appearance of typical signs of a chronic "pulmonary" heart: shortness of breath, a feeling of palpitations, fatigue, coughing, cyanosis of the lips, epigastric pulsation, accent and bifurcation of the second tone over the pulmonary artery.
Schistosomiasis intestinal intercalate is caused by parasitization of S. Intercalatum in the veins of the intestine, mesentery, portal portal system. The disease occurs in limited foci of Africa, pathogenetically and clinically similar to intestinal schistosomiasis caused by S. Mansoni. The course of the disease is benign, cases of portal fibrosis are not registered.
Symptoms of schistosomiasis of Japanese
Schistosomiasis of Japanese is caused by S. Japonicum. The male has dimensions 9.5-17.8 x 0.55-0.97 mm, the female - 15-20 x 0.31-0.36 mm. Eggs (70-100 x 50-65 microns) of round shape, on the lateral side, closer to one pole, there is a small spine.
An acute period of the disease, known as Katayama's disease. In Japanese schistosomiasis are marked much more often than when S. Mansoni and S. Haematobium are invaded . It can flow in various forms - from the lungs, asymptomatic to fulminant, with a sudden onset, severe course and death.
In chronic Japanese schistosomiasis, the intestines, liver and mesentery are mainly affected. The work of recent years shows that even among the most stricken age (children 10-14 years) gastrointestinal disorders are observed only in 44% of patients. Disturbing such symptoms of schistosomiasis of Japanese as: diarrhea, constipation or alternation; in the stool are possible mucus, blood: disturb the pain in the abdomen, flatulence. Sometimes appendicitis is detected. Skidding of eggs into the portal system leads to the fact that periportal fibrosis develops 1-2 years after the invasion, later - cirrhosis of the liver, all manifestations of portal hypertension and splenomegaly, and the spleen can grow to large sizes and become very dense. A severe and frequent complication of Japanese schistosomiasis is bleeding from the esophageal veins. Lesions of the lungs are of the same nature as in other forms of schistosomiasis. But at infestation S. Japonicum develop less often. Than with intestinal and urogenital schistosomiasis.
CNS lesion can develop in 2-4% of the invaders. Neurological symptoms of schistosomiasis of Japanese appear only 6 weeks after infection, i.e. After parasites begin to lay eggs; in most cases, these symptoms become noticeable during the first year of the disease. The most common symptom is Jackson's epilepsy. There are also signs of encephalitis, meningoencephalitis. Hemiplegia, paralysis. In advanced cases of bleeding from the esophageal dilated veins, increasing cachexia and secondary infection lead to the death of the patient.
Schistosomiasis, caused by S. Mekongi, is recorded in the Mekong River Basin in Laos, Kampuchea, Thailand. The eggs of his pathogen are similar to the eggs of S. Japonicum. but smaller. Pathogenesis and symptoms of schistosomiasis of S. Mekongi are identical to those of Japanese schistosomiasis.