From the Guidelines
Schistosomiasis symptoms typically include fever, dry cough, urticarial rash, abdominal pain, diarrhea, and pulmonary infiltrates on chest radiograph, with eosinophilia being a common laboratory finding, as seen in Katayama syndrome, which occurs early in the infection, during the migration and initiation of egg-laying phases 1. The symptoms of schistosomiasis can vary depending on the stage of infection and the species of parasite involved.
- Initially, some people may develop a rash or itchy skin (cercarial dermatitis) within days after infection when the parasites penetrate the skin.
- Within 1-2 months, acute schistosomiasis (Katayama fever) may occur, causing fever, chills, cough, and muscle aches, with an incubation period of 2-9 weeks 1.
- Chronic schistosomiasis symptoms develop gradually and depend on which organs are affected by the eggs, with intestinal schistosomiasis causing abdominal pain, diarrhea, and blood in the stool, and urinary schistosomiasis presenting with blood in urine (hematuria), painful urination, and frequent urination. The clinical presentation of Katayama syndrome includes non-specific symptoms such as fever, lethargy, myalgia, arthralgia, cough, wheeze, headache, urticarial rash, diarrhea, and hepatosplenomegaly, with almost all patients having an eosinophilia (>0.45 10 9 /L) 1. The combination of fresh-water exposure, fever, urticarial rash, and eosinophilia makes the diagnosis of Katayama syndrome likely, and empiric therapy with praziquantel should be given, with a repeat dose 6-8 weeks later, as eggs and immature schistosomes are relatively resistant to treatment 1.
From the Research
Symptoms of Schistosomiasis
The symptoms of schistosomiasis can vary depending on the species of schistosome and the organ system involved. Some common symptoms include:
- Hematuria, proteinuria, leukocyturia, dysuria, and nocturia in urinary schistosomiasis caused by Schistosoma haematobium 2
- Diarrhea, blood-tinged stool, abdominal pain, and liver cirrhosis in intestinal schistosomiasis caused by Schistosoma mansoni 2, 3
- Hepatomegaly, splenomegaly, and portal hypertension in hepatic schistosomiasis 4, 5
- Fever and headache in acute schistosomiasis 6
- Dysuria and hyperplasia in chronic infections 6
Organ-Specific Symptoms
The symptoms of schistosomiasis can also be specific to the organ system involved:
- Urinary tract: hematuria, proteinuria, leukocyturia, dysuria, and nocturia 2
- Intestine: diarrhea, blood-tinged stool, abdominal pain, and polyp formation 2, 3, 5
- Liver: hepatomegaly, splenomegaly, and portal hypertension 4, 5
- Bladder: dysuria and hyperplasia 6
Species-Specific Symptoms
The symptoms of schistosomiasis can also vary depending on the species of schistosome:
- Schistosoma haematobium: urinary schistosomiasis with symptoms such as hematuria, proteinuria, leukocyturia, dysuria, and nocturia 2
- Schistosoma mansoni: intestinal schistosomiasis with symptoms such as diarrhea, blood-tinged stool, abdominal pain, and liver cirrhosis 2, 3
- Schistosoma japonicum: symptoms similar to those of Schistosoma mansoni 6