Title: Schistosomiasis ????
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2Schistosomiasis ????
Dr.Theodor Bilharz discovered the parasite in
1851 in Cairo
3Distribution of S. mansoni and S. intercalatum
?????? (???????????)
4Distribution of S. japonicum, S. mekongi and S.
haematobium ?????? (?????,???????????)
5???? ?????? ???????? ??????????? ????????????????
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11Schistosome Life Cycle ???????
????????? -??? ?????? (?????)
??????? ????? (??,??)
????????????
Schistosomula ?????
Eggs/Day/Fluke ?? 20-200 ?? 100-300 ?? 1500-3500
Egg ??
????
Cercaria ????
Miracidum ????
Mother Sporocyst ?????
Daughter Sporocyst ????? (?????)
???? - ????
12Migration of Schistosomules ?????????
Paired Mature Worms
S. haematobium vesical venous plexus ??,?????????
S.mansoni inferior mesenteric vein ??????? S.japon
icum superior mesenteric vein ?????????
13Clinical Diseases
14Clinical Disease
Swimmers itch (Fishermans itch )
Penetration of cercariae of animal schistosomes
can cause severe dermatitis ???
itch papular rash ???? within 24 hours
15Clinical Disease
soluble excretory-secretory worm antigens (26
weeks post infection) host antibody
Katayama Fever
16Clinical Disease
Eggs passed ??????
Eggs retained in tissue ???????
S. haematobium Eggs passed in urine Haematuria
Proteinuria Dysuria S. mansoni S.
japonicum Eggs passed in feces Diarrhea with
blood and mucus
Granuloma Formation (??????)
17The cellular contents diminishes with time to be
replaced by fibroblasts and collagenous scar
18Granulomatous reaction ??????
MED MT
19Granulomatous reaction ??????
NUR
20Obstructive Uropathy ???????? in S. haemtobium
infection
? Eggs escape from the pelvic veins ? Reached the
ureters ??? and ureteric orifces ????? ?
Granuloma formation ????? ? Obstruction of
ureteres ????? ? Hydrourter ????? ?
Hydronephrosis ?? ? Uraemia ??? ?
Pseudopapilloma ?????? Egg granuloma formed
in the bladder mucosa which resemble tumors.
21Schistosomal cor pulmonale ?????? in S.
haemtobium infection
Eggs that reach the lungs by metastatic-blood spre
ad lead to periarteritis. This is followed by
fibrosis of the pulmonary arterioles with
pulmonary hypertension and, finally, enlargement
of the right heart (cor pulmonale) ??????????????
???????, ?????????????
22Colon pseudopolyposis ???????
Egg granulomata in the large intestine develop
into a papilloma-like outgrowths of the mucosa
??????????????????
23Hepatosplenomegaly ????
24Ectopic Mansoni Schistosominiasis ?????????
? CNS-paravertebral venous plexus ?????? ?
Cerebral cortical veins ?????? ? Spinial cord
compression ???? ? Cauda equiba lesion
???????? ? Subserosal veins of the abdomen
??????? ? Peritoneal granulomata ????? ? Female
genital tract ? Sterility ??? ? Cutaneous
? Itchy, punctate skine eruption ???
25Schistosome Eggs
All Schistosomes eggs are pale yellow-brown to
colorless and contains a fully developed
Miracidium
26Laboratory Diagnosis
27Laboratory Diagnosis