Early Detection of Circulating Anodic Antigen (CAA) in a Case of Acute Schistosomiasis mansoni with Katayama Fever

Abstract

A 34-year-old male developed acute Katayama fever with fever, diarrhoea, joint pains, headache, urticarial rash and eosinophilia 18 days after falling into and spending 15 min in the water during water-skiing in the outlet of the Volta river. Low anti-schistosomal antibody titres were found by the immunofluorescence assay after 4 weeks, and the first Schistosoma mansoni eggs were found in faeces after 6 weeks. Both symptoms and eosinophilia increased the first days after treatment with oxamniquine, after which he improved gradually. Examination of frozen sera by the newly developed Magnetic Beads Antigen Capture-EIA (MBAC-EIA) later demonstrated a peak in schistosomal circulating anodic antigen (CAA) levels of diagnostic significance already 4 weeks after he was infected.

Infectious Diseases and the Liver

“…Eosinophilia is present in 33–66% of patients. [84,85] Serological assays, including ELISAs for the various schistosome species, have variable sensitivities, and cannot distinguish acute from chronic infection. [83] Praziquantel 40–60mg/kg divided into 1–3 doses for one day is the treatment of choice [82,86],.…”

Prospective European-wide multicentre study on a blood based real-time PCR for the diagnosis of acute schistosomiasis

“…Moreover, the inability of serology to discriminate between active and past disease limits its clinical value for follow up investigations [10]. The detection of Schistosoma specific circulating anodic and cathodic antigens (CAA and CCA) in blood or urine, released by viable adult worms, has been tested in schistosomiasis endemic regions and sporadic experiences have been reported for the use in patients with acute schistosomiasis [11-13]. Because the sensitivity of these tests greatly depends on the worm burden, they are probably not suited for the diagnosis of schistosomiasis in travellers with rather low worm burden.…”

Acute Schistosomal Colitis Preceded by Katayama Syndrome

“…However, a peripheral eosinophilia will usually be present and often serves as an important clue. [6] Due to the lack of clinical trials in nonimmune populations, the optimal treatment regimen for Katayama syndrome is not known. [7] Praziquantel is not particularly effective in early infection, so therapy for Katayama fever is mostly supportive.…”

“…[10][11][12][13][14] For a patient coming from an endemic country with a suspected light infection, the reasonable approach for diagnosis would be serum antibody titer or polymerase chain reaction assay. [6] Other investigations include serologic tests for the detection of the parasite antigens. [15] Another means involve the demonstration of parasite eggs in the stool by microscopic examination (Kato-Katz smear).…”