How to check for schistosomiasis

Now our country's economy has developed greatly, but at the same time the environment has been greatly damaged. The most obvious thing is that people's disease rate has increased, and they are all various difficult and complicated diseases. Among them, the most troublesome is parasitic disease. Water pollution is serious nowadays. Rivers, lakes and even drinking water are polluted to varying degrees. There are many impurities in the water, and we can be infected with parasites if we are not careful. So how do you check for schistosomiasis?

Schistosoma japonicum is also called schistosoma japonicum. Schistosoma japonicum parasites most vertebrates, and the eggs pass through the vein walls into the bladder and are excreted in the urine. The larvae develop inside the intermediate host snail. The mature larvae enter the definitive host through the skin or mouth. Mansonella mansoni is found in the veins of the large and small intestines and is mainly found in Africa and northern South America. The eggs are excreted in the feces. The larvae enter the snail's body and then return to the final host through the skin. Japanese schistosome is mainly found in mainland China, Japan, Taiwan, the East Indies and the Philippines. In addition to humans, it also invades other vertebrates such as livestock and rats.

Clinical manifestations

Acute schistosomiasis

(1) It occurs in summer and autumn, mostly in people who are first infected and lack immunity, but patients with chronic schistosomiasis may also become ill if they are reinfected with a large number of cercariae.

(2) Most patients have a clear date of contact with infected water. The incubation period ranges from 23 to 73 days, with an average of about one month.

(3) Fever and serum sickness-like reactions are the prominent clinical manifestations of this disease, in addition to hepatosplenomegaly, abdominal and lung symptoms.

(4) Fever: All patients have fever, which may be intermittent fever, remittent fever, irregular low-grade fever, etc. Intermittent fever and remittent fever are the most common. In severe cases, it may manifest as retained fever. According to the degree of fever and the severity of schistosomiasis, acute schistosomiasis can be divided into three types: mild, moderate and severe.

(5) The shortest duration is about 2 weeks, while the longest duration can last for several months, but it usually lasts about one month.

(6) Serum sickness-like manifestations: urticaria, INL ductal edema, generalized superficial lymphadenopathy, and occasionally hemorrhagic purpura and bronchial asthma. The number of blood cells increases, among which the increase in eosinophils is particularly significant, which has certain diagnostic value. Hepatosplenomegaly: More than 90% of patients have an enlarged liver with tenderness, especially the left lobe. Jaundice is uncommon. More than half of the patients had mild spleen enlargement.

(7) Abdominal symptoms: More than half of the patients experience abdominal pain, diarrhea, nausea, vomiting, abdominal discomfort, etc. during the course of the disease.

(8) Pulmonary symptoms: More than half of the patients have mild cough, but the sputum is small and rarely contains mucus. Pulmonary signs are often unclear, and occasionally there may be audible hiccups or small amounts of wet hiccups. Chest X-ray findings vary, with increased lung markings early on and dot-like, cloud-like, or snowflake-like infiltration shadows at the peak of the disease. This change usually appears more than a month after the onset of the disease, but lasts for a long time.

(9) If there is myocardial damage, the electrocardiogram may show low voltage, flat or inverted T waves, and prolonged Q-T interval.

(10) Some critically ill patients may experience severe anemia, extreme weight loss, cachexia, or edema.

(11) If there is ectopic damage to the brain, corresponding symptoms and signs may occur.

Chronic schistosomiasis

(1) Small-scale repeated infections, most of which manifest as chronic schistosomiasis.

(2) Asymptomatic patients: Most patients in endemic areas belong to this category. Their health is not significantly affected and they are often found during trematode screening, routine physical examinations, or when seeking medical treatment for other diseases. A small number of patients may have mild hepatosplenomegaly, but without obvious symptoms.

(3) Symptomatic: The most common symptoms are chronic diarrhea and chronic dysentery. In mild cases, the patient has 2 to 3 bowel movements a day, occasionally with a small amount of blood and mucus; in severe cases, it is similar to an acute bacillary dysentery attack. Late-stage schistosomiasis: mainly refers to schistosomiasis-induced liver fibrosis. The course of the disease is generally more than 5 to 15 years. In the early stage of the disease, there is only hepatosplenomegaly, followed by the gradual appearance of significant symptoms of portal hypertension and varying degrees of liver decompensation.

(4) Late-stage schistosomiasis can be divided into four types: splenomegaly, ascites, colonic hyperplasia, and dwarfism, which may also exist in combination.

complication

(1) Gastrointestinal bleeding: More than two-thirds of patients with advanced schistosomiasis have varices in the lower esophagus or gastric fundus.

(2) Hepatic coma: Common causes include gastrointestinal bleeding, surgery and anesthesia, infection, water and electrolyte imbalance, excessive intake of ammonia-containing substances, etc. Sometimes there is no obvious cause. The former can usually remain conscious after eliminating the inducing cause and receiving active treatment; the latter is often a manifestation of complete liver failure. Responds poorly to all treatments.