What is the disease progression of chronic schistosomiasis (bilharzia)?

Updated: Sep 20, 2018
  • Author: Shadab Hussain Ahmed, MD, AAHIVS, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Egg retention and granuloma formation in the bowel wall (usually S mansoni or S japonicum) may cause bloody diarrhea, cramping, and, eventually, inflammatory colonic polyposis. Patients with heavy bowel wall involvement have an increased rate of recurrent Salmonella infection, generally with positive blood cultures and negative stool cultures. Chronic intestinal schistosomiasis can present with acute complications of appendicitis, [17, 18] perforation, and bleeding long after travel-related (or endemic) exposure. Rectal perforation caused by S haematobium has also been described in a case report. [19]

Eggs can penetrate the bowel adjacent to mesenteric vessels where adult worms are residing. Unshed eggs, which are swept back to the portal circulation, lodge there and induce granulomatous reactions in the portal tracts.


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