Reversed halo sign in acute schistosomiasis

Souza, Arthur Soares; Souza, Antônio Soares; Soares-Souza, Luciana; Zanetti, Gláucia; Marchiori, Edson

doi:10.1590/s1806-37132015000004444

Cited by 4 publications

(9 citation statements)

References 6 publications

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“…The presence of eggs in the very early phase of schistosomiasis is reported in some papers: as early as 3 weeks after exposure in the lungs [9], 4 weeks in stool [11,45], 5 weeks in a biopsy of the skin [51]. These findings confirm that the oviposition sometimes starts very early, before what was previously thought (6-7 weeks).…”

Section: As and Lung Nodules: Literature Reporting Very Early Oviposisupporting

confidence: 63%

“…Worthy of note, another four cases of pulmonary nodules in CS were afterwards detected in the same center [34]; moreover, a case series of 17 cases [35] and other single cases were reported [36][37][38]. Second, the characteristics of the lung lesions in these patients with CS resembled those described by other groups during AS: transient macronodules, micronodules [11,39,40], and nodules with 'ground-glass' attenuation areas [6,7,9,[41][42][43][44][45]. These were obviously very different from the lung manifestations described in some patients with advanced-stage CS, that is, irreversible pulmonary arterial hypertension but no lung nodules [13,46,47].…”

Section: Old and Recent Findings Suggest A Rethinking Of The Ways In mentioning

confidence: 65%

“…Pulmonary manifestations of AS, when present, are sometimes associated with radiological features usually described as ill-defined nodules and 'ground-glass' areas [6][7][8]. Such radiological abnormalities have been reported to develop even as early as 3 weeks after exposure, along with documentation of eggs in pulmonary tissue [9]. In CS, the adult worms live in the venous mesenteric or vesical plexuses (depending on the species), where they lay hundreds to thousands of eggs daily for several years.…”

Section: The Pathophysiology and Duration Of The Early Phase Of Schismentioning

confidence: 99%

See 2 more Smart Citations

New Insights on Acute and Chronic Schistosomiasis: Do We Need a Redefinition?

Gobbi

Tamarozzi

Buonfrate

et al. 2020

Trends in Parasitology

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Section: As and Lung Nodules: Literature Reporting Very Early Oviposisupporting

confidence: 63%

Section: Old and Recent Findings Suggest A Rethinking Of The Ways In mentioning

confidence: 65%

Section: The Pathophysiology and Duration Of The Early Phase Of Schismentioning

confidence: 99%

See 1 more Smart Citation

New Insights on Acute and Chronic Schistosomiasis: Do We Need a Redefinition?

Gobbi

Tamarozzi

Buonfrate

et al. 2020

Trends in Parasitology

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“…These lesions have been observed in patients as early as 4 weeks post infection, and can occur prior to eggs being detectable in stool (15, 52). Nodular lesions have been shown to occur in response to clusters of schistosome eggs, with histological analysis of lung biopsies revealing eosinophilic granulomas surrounding these eggs (53). However, recent studies have supported the idea that egg deposition is not required for Katayama syndrome (54,55).…”

Section: Symptoms and Immunology Of Acute Schistosomiasismentioning

confidence: 99%

Schistosomes in the Lung: Immunobiology and Opportunity

et al. 2021

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Schistosome infection is a major cause of global morbidity, particularly in sub-Saharan Africa. However, there is no effective vaccine for this major neglected tropical disease, and re-infection routinely occurs after chemotherapeutic treatment. Following invasion through the skin, larval schistosomula enter the circulatory system and migrate through the lung before maturing to adulthood in the mesenteric or urogenital vasculature. Eggs released from adult worms can become trapped in various tissues, with resultant inflammatory responses leading to hepato-splenic, intestinal, or urogenital disease – processes that have been extensively studied in recent years. In contrast, although lung pathology can occur in both the acute and chronic phases of schistosomiasis, the mechanisms underlying pulmonary disease are particularly poorly understood. In chronic infection, egg-mediated fibrosis and vascular destruction can lead to the formation of portosystemic shunts through which eggs can embolise to the lungs, where they can trigger granulomatous disease. Acute schistosomiasis, or Katayama syndrome, which is primarily evident in non-endemic individuals, occurs during pulmonary larval migration, maturation, and initial egg-production, often involving fever and a cough with an accompanying immune cell infiltrate into the lung. Importantly, lung migrating larvae are not just a cause of inflammation and pathology but are a key target for future vaccine design. However, vaccine efforts are hindered by a limited understanding of what constitutes a protective immune response to larvae. In this review, we explore the current understanding of pulmonary immune responses and inflammatory pathology in schistosomiasis, highlighting important unanswered questions and areas for future research.

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“…Recent studies conducted in Brazil 1 - 3 have stressed the importance of the reversed halo sign (RHS) in the diagnosis of lung diseases in immunocompetent patients. However, the RHS in immunocompromised patients has not received the same emphasis.…”

Section: To the Editormentioning

confidence: 99%