Schistosomiasis mansoni and severe gastrointestinal cytomegalovirus disease in a patient with acquired immunodeficiency syndrome

Ávila, Renata Eliane de; Batista, Thaís Sanai; Xavier, Marcelo Antônio Pascoal; Nogueira, Ana Margarida Miguel Ferreira; Lambertucci, José Roberto

doi:10.1590/s0037-86822006000400012

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…There are three main clinical patterns of schistosomiasis in such cases, namely gastrointestinal, disseminated and neurological. Gastrointestinal schistosomiasis is the most common and typically presents with weight loss, diarrhoea, abdominal pain and odynophagia [59] .…”

Section: Co-infectionmentioning

confidence: 99%

Human Schistosomiasis: Clinical Perspective: Review

Barsoum

Esmat

Elbaz

2013

Journal of Advanced Research

156

146

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The clinical manifestations of schistosomiasis pass by acute, sub acute and chronic stages that mirror the immune response to infection. The later includes in succession innate, TH1 and TH2 adaptive stages, with an ultimate establishment of concomitant immunity. Some patients may also develop late complications, or suffer the sequelae of co-infection with other parasites, bacteria or viruses. Acute manifestations are species-independent; occur during the early stages of invasion and migration, where infection-naivety and the host’s racial and genetic setting play a major role. Sub acute manifestations occur after maturity of the parasite and settlement in target organs. They are related to the formation of granulomata around eggs or dead worms, primarily in the lower urinary tract with Schistosoma haematobium, and the colon and rectum with Schistosoma mansoni, Schistosoma japonicum, Schistosoma intercalatum and Schistosoma mekongi infection. Secondary manifestations during this stage may occur in the kidneys, liver, lungs or other ectopic sites. Chronic morbidity is attributed to the healing of granulomata by fibrosis and calcification at the sites of oval entrapment, deposition of schistosomal antigen-antibody complexes in the renal glomeruli or the development of secondary amyloidosis. Malignancy may complicate the chronic lesions in the urinary bladder or colon. Co-infection with salmonella or hepatitis viruses B or C may confound the clinical picture of schistosomiasis, while the latter may have a negative impact on the course of other co-infections as malaria, leishmaniasis and HIV. Prevention of schistosomiasis is basically geared around education and periodic mass treatment, an effective vaccine being still experimental. Praziquantel is the drug of choice in the treatment of active infection by any species, with a cure rate of 80%. Other antischistosomal drugs include metrifonate for S. haematobium, oxamniquine for S. mansoni and Artemether and, possibly, Mirazid for both. Surgical treatment may be needed for fibrotic lesions.

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Section: Co-infectionmentioning

confidence: 99%

Human Schistosomiasis: Clinical Perspective: Review

Barsoum

Esmat

Elbaz

2013

Journal of Advanced Research

156

146

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“…In endemic areas, schistosomotics are frequently heavy drinkers. Is there really a place in the world for pure schistosomiasis 74,75,[76][77][78][79][80][81][82] ?…”

Section: Pure Schistosomiasismentioning

confidence: 99%

Revisiting the concept of hepatosplenic schistosomiasis and its challenges using traditional and new tools

Lambertucci

2014

Rev. Soc. Bras. Med. Trop.

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Different aspects of hepatosplenic schistosomiasis are revisited here. Manson's schistosomiasis causes periportal fi brosis and portal hypertension in approximately 6% of infected subjects, usually with preservation of their hepatic function. The assessment of liver involvement is of major importance in determining the prognosis and risk of complications from schistosomiasis, such as upper digestive bleeding secondary to variceal rupture. For many years, the diagnosis of hepatosplenic schistosomiasis and liver fi brosis was made by abdominal palpation and the fi nding of liver and/or spleen enlargement. However, there is no consensus regarding the clinical parameters of the liver and spleen to be considered in this physical evaluation. For the last three decades, abdominal ultrasound (US) has become the best imaging technique to evaluate liver fi brosis caused by schistosomiasis mansoni. However, US is a subjective procedure and is therefore examiner-dependent. Magnetic resonance imaging (MRI) fi ndings have provided valuable information in addition to ultrasound and clinical examination. The combination of a comprehensive history and physical examination, basic laboratory tests (a stool examination for Schistosoma mansoni eggs and a blood cell count), biomarkers for liver fi brosis/portal hypertension and imaging methods seem to offer the best approach for evaluating patients with this disease. In situations where research is involved or in patients with severe disease, MRI may be considered.

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“…There are three main clinical diagnoses of schisto-somiasis (gastrointestinal, disseminated and CNS) reported in HIV-infected patients. Gastrointestinal schistosomiasis is the most common form and patients typically present with weight loss, diarrhoea, abdominal pain and odynophagia62. Only a few cases of disseminated and neurkoschistosomiasis (NSS) have been reported in HIV-infected patients63.…”

Section: Diseases Due To Tissue Parasites In Hiv/aids Patientsmentioning

confidence: 99%

Parasitic infections in HIV infected individuals: Diagnostic & therapeutic challenges

Nissapatorn¹,

Sawangjaroen²

2011

Indian J Med Res

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After 30 years of the human immunodeficiency virus (HIV) epidemic, parasites have been one of the most common opportunistic infections (OIs) and one of the most frequent causes of morbidity and mortality associated with HIV-infected patients. Due to severe immunosuppression, enteric parasitic pathogens in general are emerging and are OIs capable of causing diarrhoeal disease associated with HIV. Of these, Cryptosporidium parvum and Isospora belli are the two most common intestinal protozoan parasites and pose a public health problem in acquired immunodeficiency syndrome (AIDS) patients. These are the only two enteric protozoan parasites that remain in the case definition of AIDS till today. Leismaniasis, strongyloidiasis and toxoplasmosis are the three main opportunistic causes of systemic involvements reported in HIV-infected patients. Of these, toxoplasmosis is the most important parasitic infection associated with the central nervous system. Due to its complexity in nature, toxoplasmosis is the only parasitic disease capable of not only causing focal but also disseminated forms and it has been included in AIDS-defining illnesses (ADI) ever since. With the introduction of highly active anti-retroviral therapy (HAART), cryptosporidiosis, leishmaniasis, schistosomiasis, strongyloidiasis, and toxoplasmosis are among parasitic diseases reported in association with immune reconstitution inflammatory syndrome (IRIS). This review addresses various aspects of parasitic infections in term of clinical, diagnostic and therapeutic challenges associated with HIV-infection.

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Schistosomiasis mansoni and severe gastrointestinal cytomegalovirus disease in a patient with acquired immunodeficiency syndrome

Cited by 3 publications

References 13 publications

Human Schistosomiasis: Clinical Perspective: Review

Human Schistosomiasis: Clinical Perspective: Review

Revisiting the concept of hepatosplenic schistosomiasis and its challenges using traditional and new tools

Parasitic infections in HIV infected individuals: Diagnostic & therapeutic challenges

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