The schistosomiasis

Schistosomiasis (synonym bilharziose) - helminthiasis, causative agents of which are parasites in the blood vessels of the abdominal cavity. Here females lay eggs that are moving into the intestine or the bladder and allocated out with the feces or urine. When released into water, the eggs out germs (miracidia)that are embedded in shellfish. In shellfish is the development and reproduction of larvae of ending the release into water of larvae - cercarial. Human infection occurs due to the implementation of cercarial through the skin when bathing and water bodies; infection is possible and by drinking water with larvae. The schistosomiasis distributed among the people of tropical countries. There are genitourinary, gastrointestinal Munson and Japanese schistosomiasis.
The urinary schistosomiasis. The disease is caused by Schistosoma haematobium. The male 4 - 15 mm, female up to 20 mm In the early phases of schistosomiasis (snail fever - fever, allergic skin rashes, eosinophilic pulmonary infiltrates. In late phase - frequent, painful urination, terminal hematuria (bleeding in the end of urination), less total hematuria. On the bladder wall - erosion, small ulcers, schistosomatidae tubercles (clusters of eggs of Schistosoma), calcifications. Women colpitis, polyps in the vagina and on the cervix. Men - epididimita, prostatitis, the defeat of the seminal vesicles. The diagnosis is based on detection in urine sediment eggs of Schistosoma with a pin on one end and the characteristic changes in the mucous membrane of the urinary bladder during cystoscopy.
The intestinal schistosomiasis Munson. The Disease Is Caused By Schistosoma Mansoni. The length of the male - 10 mm, females - 15 mm In an early phase - allergic phenomena in late - rapid chair with admixture of mucus and blood, tenesmus. When rectoromanoscopy find hyperemia of the mucous membrane of the intestines, sometimes erosion and small ulcers; precipitation of colon and intestine polyposis; due to the introduction of eggs in the liver hepatitis. The diagnosis is based on detection in Calais eggs with a side thorn.
The schistosomiasis Japanese. The disease is caused by Schistosoma japonicum. The length of the male to 18 mm, females up to 20 mm Flows as intestinal schistosomiasis of Munson, but in more severe forms. Possible complications: in the result of introduction of eggs in the brain develops meningoencephalitis, the syndrome of the Central nervous system tumors. The diagnosis is based on detection in Calais eggs with rudimentary or hooked thorns.
Treatment of schistosomiasis is carried out mainly drugs trivalent antimony - windowredraw salt and other Windowmanager salt (Stibionatrium tartaricum) enter only into a vein in the form of 1% solution every day or every other day in incremental doses of 0.03 to 0.1 grams of the drug (3-10 ml) per injection; total course dose of 1-1,5 grams of the drug (100 - 150 ml). The duration of treatment about 1 month.
Prevention. In areas of distribution of schistosomiasis bathing is prohibited standing in the water and slowly flowing water bodies, walking barefoot on the wet ground and wet grass, where can be cercariae; be sure to water boiling or filtering it through the canvas.
Cm. also the Trematodozov.

The schistosomiasis (schistosomatoses) - a group of parasitic infection caused diclinous trematodes family Schistosomatidae.
The causative agents of schistosomiasis are three types of worm: Schistosoma haematobium, S. mansoni, S. japonicum,is a parasite in the blood vessels, where the females lay eggs. Last penetrate the walls of blood vessels, into the cavity bladder or intestine lumen and excreted in urine or feces. In water, the eggs hatch miracidia; they are embedded in the intermediate hosts - molluscs, in which there is a development and asexual reproduction the larvae of ending the release into water cercarial. Cercariae actively penetrate through the skin and the mucous membranes in the body of humans and animals. In the body young worms migrate, reach the venous system of the abdominal cavity, where develop until puberty. Source of infestation for shellfish is a sick man, and when the Japanese schistosomiasis, also, and animals (pollution faeces and urine reservoirs). Human infection with schistosomiasis occurs when bathing and water bodies inhabited by mollusks, and also by drinking water from these water bodies. Infection is possible and when in contact with wet grass, on which creep shellfish.
Pathogenic impact schistosomes associated with sensitization of an organism products of metabolism of worms and possibly autoallergy master, mechanical influence young worms on a fabric during migration, Mature schistosomes and their eggs, intoxication proteolytic secrets and products of metabolism cercarial, adult schistosomes and prisoners in eggs of miracidial.
When schistosomiasis are created favorable conditions for the occurrence of tumors of the bladder, intestines and liver.
There are urinary, and intestinal schistosomiasis; there is also a Japanese schistosomiasis.
The urinary schistosomiasis - Schistosomatosis urogenitalis [synonym bilharziosis (bilharziasis) urogenitalis] - proceeds from the primary lesion of urogenital organs. Spread in several countries of Africa and Asia.

Fig. 1. Schistosoma haematobium: 1 - male, 2 - female; 3 - head end of the male; 4 and 5 eggs; 6 and 7 of miracidia; 8 - cercariae; 9 - molluscum Bullinus dybowski (increased).

Pathogen - S. haematobium (Billiarz, 1852; synonym Bilharzia haematobia). Male long 4-15 mm, 1 mm wide, female 20X0,25 mm (Fig. 1). The egg is oval, with a spike at one of the poles. In the stage of puberty parasites in humans and monkeys in the portal vein, mesenteric veins and bladder. Eggs are excreted in the urine. The intermediate hosts of helminth - shellfish Bullinus truncatus and other Moment of penetration cercarial through the epidermis into the lymphatic system and through the mucous membranes often goes by quickly, sometimes itchy dermatitis. When migrating larvae can be allergic phenomena in the form of volatile pulmonary infiltrate, fever, respiratory catarrh, increased liver and spleen, eosinophilia of blood. After 2-3 months. and more, there are signs of defeat of the bladder, which is associated with the trauma of tissues eggs of helminths. There are various changes of the mucous membrane - hyperemia, hemorrhage, erosion, schistosomatidae tubercles (clusters of eggs), "sandy spots" (accumulation calcified eggs), polypous expansion, scars. Often there are complications in the form of ureteral strictures, pielonefrita, bladder stones. Skid eggs in other organs may cause lung bleeding, brain damage, etc. are Often the only manifestation of the disease is terminal hematuria - allocation of blood at the end of urination. In more severe cases may be pain in the lumbar region, dysuria, malaise, headache, various allergic phenomena, eosinophilia. The diagnosis is based on detection in urine sediment eggs and typical changes of the mucous membrane of the urinary bladder during cystoscopy. Sometimes the purpose of diagnosis resort to indonesiennes biopsy.


The intestinal schistosomiasis Munson [schistosomatosis intestinalis Mansoni; synonym bilharziosis (bilharziasis) intestinalis Mansoni] - disease proceeding with symptoms of bowel and liver. Spread in several countries in Africa, Brazil, Venezuela, Puerto Rico. Pathogen - S. mansoni (Sambon, 1907; a synonym Bilharzia mansoni), male 10 mm and 1.2 mm wide, female - 15x0,17 mm (Fig. 2). The egg is oval, with lateral spine, their rate of 0.12-0,H,06X0,07 mm

Fig. 2. Schistosoma mansoni: 1 - egg; 2 - a male to female (increased).

In the stage of puberty parasitizes in the veins of the abdomen, bowel, where the females lay eggs that penetrate the intestinal lumen and eye-catching with faeces (occasionally with urine). The intermediate hosts of helminth - shellfish birth SP, Physopsis, and other Bullinus
In the early stage is sometimes fever, urticaria, enlarged liver and spleen, eosinophilia. In the late stage is dominated by the symptoms of colitis - pain in the abdomen, diarrhea, constipation, tenesmus, mucus and blood in the stool, low-grade fever. In complicated cases - polyposis of the mucous membrane of the large intestine, hemorrhoids, loss of mucous membrane of the rectum, signs of liver cirrhosis, ascites. Sometimes subclinical, but in these cases, if rectoromanoscopy often reveals specific changes as small whitish-yellowish knots like semolina, scattered on hyperemic and swollen mucosa.
Complications of cirrhosis of the liver, brain with the development of paralysis, epileptiform seizures, lung heart, colon cancer, and liver.
The diagnosis is based on clinical and rectoromanoscopy data and detection of eggs in the stool, scraping from a mucous membrane of the rectum and in the tissues of the colon and liver biopsy).
The schistosomiasis Japanese [schistosomatosis japonica; synonym bilharziosis (bilharziasis) japonica] - natural focal disease occurring mainly affecting the digestive system (intestines, liver). Distributed in southern China, the Philippines, in southern Japan.
Pathogen - S. japonicum Katsurada (1904); the male 9,5 about 17.8 mln mm long and 0.55 to 0.97 mm wide, female 15-20 mm long and 0.31-0.36 mm width (Fig. 3).

Fig. 3. Schistosoma Japonicum: 1 male to female; 2 - egg; 3 - miracidia; 4 - molluscum Onchomelania schmakeri; 5 - cercariae.

Eggs are oval size 0,074-0,H,06-0,08 mm hooked with or vestigial side thorn. In the stage of puberty parasitizes in the gate and mesenteric veins of human and mammalian animals (horses, pigs, dogs, cats, cattle and small cattle, monkeys, rats, mice and other). Eggs are excreted into the environment with faeces. The intermediate hosts molluscs of the genus Onchomelania.
By morphological manifestations Japanese schistosomiasis reminds intestinal schistosomiasis of Munson, but it is more often increase and liver cirrhosis, ascites, lesion of Central nervous system, intellectual and physical development of children. The diagnosis is based on clinical and historical data, ovoscope faeces, scrapings from the mucous membrane of the rectum and biopsyproven segments of the intestine and Pankratov liver.
Treatment of schistosomiasis out in a hospital under the supervision of ECG. Using drugs trivalent antimony - emetic stone (windowmanagement salt), windowmanager salt, Fadin, and with urogenital : schistosomiasis - mirazi D (nologin).
The course of treatment consists of 12 intravenous injection of 1% solution vomiting stone or windowredraw salt, which makes every other day for 4 weeks. The initial dose of 0.03 g (3 ml of 1% solution) gradually increase to 0.1 g (10 ml 1% solution). Heading dose for adult 1 to 1.5 g (100-150 ml of 1% solution).
Recommended and 6% solution vomiting stone or windowredraw salt distilled water. A single dose is calculated at the rate of 0.5 ml of 15 kg body weight of the patient, maximum single dose of 2 ml (i.e. 120 mg drug). The maximum dose rate to 24 ml 6% solution in urogenital the schistosomiasis and 32 ml for intestinal schistosomiasis of Munson and Japanese. The drug is injected slowly after 2 days on the third. The first injection - polosy.
Fadin intramuscularly first three doses daily, the rest in a day: at first injection shall 1.5 ml, in the second - 3.5 ml, subsequent to 5 ml of the drug, just 10 - 15 injection. For children, single dose 0.1 ml per 1 kg of body weight.
Miracel D are inside adults and 200 mg 2-3 times a day after meals for 2-3 weeks.
Schistosomatidae dermatitis (dermatitis schistosomatida) is called by the implementation of the skin cercarial schistosomes when working in contaminated waters. During primary infection appear itching, maloletnie rash, when re - papules, blisters, swelling of the skin. The forecast is favorable. Treatment: ointment containing 5% Dimedrol, diphenhydramine inside.
Prevention of schistosomiasis. Identification and treatment of patients and parasite-vectors; protection of waters and soil against pollution of fresh faeces and urine. During the 7-day fermentation urine and feces at the temperature of 15-20 degrees of the eggs of Schistosoma die. The destruction of intermediate hosts of systematic - clams - in ponds, rice fields, sports pools. In areas of distribution of schistosomiasis prohibited bathing in water bodies, walking barefoot on the wet ground and wet grass, where can be cercariae; be sure to boil water. If necessary, work in dangerous waters should be used with special clothes and footwear, lubricate the skin ointment containing dietilftalat.