Lec.

2: Schistosomiasis Schistosoma hematobium

Blood fluke infection, portal-vascular system of animals, S.mansoni, hematobium and japonicum S.japonicum enters the SMV then reach the small intestines and ascending colon, while S.mansoni and hematobium are directed to the IMV. S.hematobium passes and rest in the venous plexus of bladder and pelvic organs, oviposition in submucosal venules, the Ova rupture and pass outside in the urine. Eggs in fresh water skin penetration. miracidia snail host cercariae (infectious larvae) human

after penetration small venules circulation distributed to the gut.

right side of the heart

lungs

back to systemic

schistosomiasis is the single most important helminthic infection in the world today. the continued presence of the parasite depends on: 1-disposal of infected human excrement into fresh water. 2-the availability of snail hosts. 3-exposure to water infected with cercariae. 3 pathologic stages: 1-1 stage is penetration and migration. 2- 2 or intermediate stage oviposition and clinical manifestation. 3- 3rd or chronic stage granuloma formation and scarring. in the early stage, S.hematobium causes immediate and delayed hypersensitivity that causes pruritic popular rash, then after migration to the liver the rash disappear and fever, headache and abdominal pain appear. In the intermediate stage acute febrile illness that resemble to serum sickness, and the patient experience urticaria, cough, arthralgia and lymphoadenopathy. the chronic stage, inflammation and scarring are stimulated by soluble antigens of the eggs. And the severity of damage is related to number of eggs retained. in S.hematobium the bladder mucosa thickened papillated and ulcerated. Hematuria, dysuria and anemia result. Involvement of muscular layers leads to lose of bladder contractibility. Obstruction leads to renal failure and uremia. And bladder carcinoma is seen. The diagnosis based on finding the characteristic eggs in urine or biopsy specimens. S.hematobium eggs are found in samples taken at midday. Serologic tests detect antibodies but cannot distinguish active from inactive infections. no specific treatment. Antihistamines and corticosteroids help in ameliorating ( manifestations. Praziquantel is the agent of choice. there is no effective vaccine. ) the
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Ayman Hajeer ;)