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Schistosomiasis. Pathophysiology, diagnosis, and treatment.
Gastroenterol Clin North Am. 1996 Sep; 25(3):599-625.GC

Abstract

Globally, schistosomes infect 1 in 30 people. Tourists travel to endemic areas, whereas students, workers, and expatriates travel to nonendemic areas. Physicians around the world need to remain aware of this common parasitic infection. Pathology results from parasite eggs that lodge in the intestines and liver. Intestinal schistosomiasis is most often asymptomatic and presents with occult gastrointestinal bleeding. Hepatosplenic schistosomiasis develops insidiously because of cumulative fibrotic injury. Stigmata of liver failure are absent unless comorbid viral or alcoholic hepatitis is present. Patients with end-stage hepatosplenic schistosomiasis die from variceal hemorrhage. Diagnosis of schistosomiasis is confirmed by finding eggs in stool or biopsy specimens. Antischistosome antibodies may identify infected tourists returning from endemic areas. Circulating schistosome antigens distinguish current from past infections. Praziquantel is the schistosomicidal drug of choice. Most cases of hepatosplenic schistosomiasis resolve after effective treatment. Prophylactic propranolol may prevent hemorrhage in praziquantel-treated patients with high-grade varices. Sclerotherapy is also efficacious. When necessary, patients with hepatosplenic schistosomiasis tolerate decompressive surgery well.

Authors+Show Affiliations

Division of Gastroenterology, University of Iowa Hospitals and Clinics, Iowa City, USA.

Pub Type(s)

Case Reports
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.
Review

Language

eng

PubMed ID

8863042

Citation

Elliott, D E.. "Schistosomiasis. Pathophysiology, Diagnosis, and Treatment." Gastroenterology Clinics of North America, vol. 25, no. 3, 1996, pp. 599-625.
Elliott DE. Schistosomiasis. Pathophysiology, diagnosis, and treatment. Gastroenterol Clin North Am. 1996;25(3):599-625.
Elliott, D. E. (1996). Schistosomiasis. Pathophysiology, diagnosis, and treatment. Gastroenterology Clinics of North America, 25(3), 599-625.
Elliott DE. Schistosomiasis. Pathophysiology, Diagnosis, and Treatment. Gastroenterol Clin North Am. 1996;25(3):599-625. PubMed PMID: 8863042.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Schistosomiasis. Pathophysiology, diagnosis, and treatment. A1 - Elliott,D E, PY - 1996/9/1/pubmed PY - 1996/9/1/medline PY - 1996/9/1/entrez SP - 599 EP - 625 JF - Gastroenterology clinics of North America JO - Gastroenterol Clin North Am VL - 25 IS - 3 N2 - Globally, schistosomes infect 1 in 30 people. Tourists travel to endemic areas, whereas students, workers, and expatriates travel to nonendemic areas. Physicians around the world need to remain aware of this common parasitic infection. Pathology results from parasite eggs that lodge in the intestines and liver. Intestinal schistosomiasis is most often asymptomatic and presents with occult gastrointestinal bleeding. Hepatosplenic schistosomiasis develops insidiously because of cumulative fibrotic injury. Stigmata of liver failure are absent unless comorbid viral or alcoholic hepatitis is present. Patients with end-stage hepatosplenic schistosomiasis die from variceal hemorrhage. Diagnosis of schistosomiasis is confirmed by finding eggs in stool or biopsy specimens. Antischistosome antibodies may identify infected tourists returning from endemic areas. Circulating schistosome antigens distinguish current from past infections. Praziquantel is the schistosomicidal drug of choice. Most cases of hepatosplenic schistosomiasis resolve after effective treatment. Prophylactic propranolol may prevent hemorrhage in praziquantel-treated patients with high-grade varices. Sclerotherapy is also efficacious. When necessary, patients with hepatosplenic schistosomiasis tolerate decompressive surgery well. SN - 0889-8553 UR - https://www.unboundmedicine.com/medline/citation/8863042/Schistosomiasis__Pathophysiology_diagnosis_and_treatment_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0889-8553(05)70265-X DB - PRIME DP - Unbound Medicine ER -
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