A new approach to the treatment of acute schistosomiasis

Abstract

Clinical and experimental evidence indicates that steroids act synergistically with schistosomicides in the treatment of Katayama syndrome. Due to the low efficacy of schistosomicides in the acute toxaemic phase of schistosomiasis, some authors have suggested that specific treatment for schistosomiasis should be delayed, in these patients, until the disease has entered it's chronic stage (Stuiver, 1984; Harries and Cook, 1987). A dramatic improvement (quick amelioration of symptoms and higher cure rates) was observed when patients with acute schistosomiasis were treated with steroids and schistosomicides. We do not know the explanation for the synergistic effect between steroids and schistosomicides but it has been demonstrated that the association of drugs affected, in some way, the fecundity of S. mansoni worms. The data and arguments presented here reinforce the need to use steroids in conjunction with schistosomicides for the treatment of patients with Katayama syndrome. This approach will give better cure rates, speed the recovery time (reducing the demand for hospital treatment) and improve the quality of medical care.

Acute Schistosomiasis: Report on Five Singular Cases

“…As we know, praziquantel kills the worms a few hours after treatment but oxamniquine takes 7 to 10 days to have the same effect (unpublished observations). This should explain the recurrence of symptoms in patient 2, 9 hr after being treated with praziquantel and the late and evanecent signs of pulmonary involvement (8 days after treatment with oxamniquine) observed in patient 3 (Lambertucci 1989).…”