Bilharzioses invasives

Abstract

Schistosomiasis is a tropical helminthic infection, observed in travelers as well as local populations. It is most often due to Schistosoma mansoni or Schistosoma haematobium and can be diagnosed at the invasive phase. Migration of the schistosomulae (larvae) in the body leads to acute parasitic toxemia, which includes a hypersensitivity reaction and circulating immune complexes. The invasive stage occurs generally 2 to 6 weeks after the exposure and combines fever, asthenia, faintness and headaches. Other signs include diarrhea, dry cough, dyspnea, urticarial rash, arthralgia, myalgia, and enlargement of liver and spleen. Although rare, neurological and cardiac complications may be fatal. This diagnosis should be considered in travelers returning from the tropics with compatible clinical signs and delayed hypereosinophilia, if they report exposure in an endemic area. It is later confirmed by seroconversion for schistosomiasis and then by observation of schistosome eggs in stool or urine (according to species). The standard treatment of acute schistosomiasis with praziquantel is ineffective and can aggravate clinical outcome during this phase. Corticosteroid treatment is recommended for serious forms with neurological or cardiac manifestations.

Urinary schistosomiasis: report of case diagnosed in bladder biopsy

“…S. haematobium was discovered by a German physician, Theodor Bilharz, during an autopsy in Egypt in 1851 [5, 6]. To date, S.haematobium infection is still prevalent in sub-Saharan Africa and parts of the Middle East [2]. Our patient was in mauritania which is a contact point between north africa and sub-saharan africa.…”

“…Of these, only five infect the human being, that is Schistosoma mansoni , Schistosoma japonicum [2–5], S. haematobium , Schistosoma mekongi and Schistosoma intercalatum. The first three are the most frequent.…”

Myocarditis during Acute Schistosomiasis in Two Travelers

“…It is considered as a systemic hypersensitivity reaction against the migrating schistosomulae in tissue. 1,6,7 It's usually self-limited and subsides over a few weeks, although lifethreatening complications have been described that were mainly neurological. 2,8,9 In our two cases, the first signs of AS appeared 26 and 27 days after the exposure, respectively.…”

“…In both cases the patients were nonimmune travelers presenting with hypersensitivity symptoms and eosinophilia characteristics of AS. 1,6,11 The involved species is S. haematobium according to the results of urinalysis in the second patient; the first patient bathed in the same area of Mali .…”

“…6 Eosinophils play an essential role in the regulation of allergy and in the protection against helminthiasis with the aid of proteins contained in their granules such as the MBP (Major Basic protein) and the ECP (Eosinophilic Cationic Protein).…”