UNASSIGNED: Katayama syndrome is an acute manifestation of schistosomiasis, a parasitic infection that manifests itself through a hypersensitivity reaction to migrating larvae and early egg deposition. Left undiagnosed and untreated, acute schistosomiasis can develop into chronic schistosomiasis which can lead to debilitating morbidity such as pulmonary hypertension. This case highlights that Katayama syndrome can also been seen in regions where the parasite is not endemic, as it occurs in travelers returning from endemic regions or in immigrants.
UNASSIGNED: We describe the case of a 26-year-old asthmatic male, who presented with systemic symptoms including fever, myalgia, night sweats as well as gastro-intestinal and pulmonary complaints since five days. At presentation, there was a raised blood eosinophil count and nodular lesions were seen on computed tomography. After considering diagnoses such as tuberculosis, vasculitis and hypereosinophilic syndrome, it was repeated history taking that revealed that the patient had suffered from swimmer\'s itch during a stay in Guinea. A stool sample showed microscopic presence of Schistosoma mansoni eggs, confirming the diagnosis of Katayama syndrome. The patient was treated with tapered corticosteroids to suppress the hypersensitivity reaction and praziquantel was added to cure the parasitic infection. This led to a complete resolution of the patients\' symptoms and radiological abnormalities. Negative stool samples confirmed the eradication of the schistosomes.
UNASSIGNED: Swimmer\'s itch and Katayama syndrome are manifestations of acute schistosomiasis. It is important to recognize the syndrome, because early diagnosis and adequate treatment can prevent chronic disease and significant morbidity.

Acute schistosomiasis (ASC) is a hypersensitivity reaction seen mostly in nonimmune travelers and manifests mainly with fever, urticaria, and respiratory symptoms. We describe unusual severe presentations of ASC in 3 patients, including hip-monoarthritis, peri-myocarditis, and optic neuritis. In all 3 patients, clinical symptoms appeared or worsened after praziquantel administration.

While chronic schistosomiasis is pathologically well defined, the acute form of the disease is less well understood. It is generally agreed that early lesions, such as lung nodules and bladder polyps, are reversible, which impedes identification of the time elapsed since exposure. The intermediate stage between the acute and the chronic forms of schistosomiasis requires further investigation, as does the clinical stage due to lesions remaining after treatment. With current schistosomiasis control efforts gradually progressing to elimination, there is a need to focus on post-transmission schistosomiasis, which not only refers to remaining lesions from previous infections, but also accounts for the potential presence of surviving worms after treatment. This issue is particularly salient for migrants from endemic to non-endemic countries and should be kept in mind for returning expatriates from schistosomiasis-endemic countries. Negative stool examination or urine filtration are generally taken as indicative of cure since rectoscopy for Schistosoma mansoni infection, or cystoscopy for S. haematobium infection, are rarely performed. However, pathology of affected organs may persist indefinitely, while potentially remaining live worms could produce additional pathology. Hence, post-transmission schistosomiasis can prevail for years after elimination of the disease, and thus, warrant further attention.

Schistosomiasis is a helminthic infection and one of the neglected tropical diseases (NTDs). It is caused by blood flukes of the genus Schistosoma. It is an important public health problem, particularly in poverty-stricken areas, especially those within the tropics and subtropics. It is estimated that at least 236 million people worldwide are infected, 90% of them in sub-Saharan Africa, and that this disease causes approximately 300,000 deaths annually. The clinical manifestations are varied and affect practically all organs. There are substantial differences in the clinical presentation, depending on the phase and clinical form of schistosomiasis in which it occurs. Schistosomiasis can remain undiagnosed for a long period of time, with secondary clinical lesion. Here, we review the clinical profile of schistosomiasis. This information may aid in the development of more efficacious treatments and improved disease prognosis.

暂无摘要。

Acute schistosomiasis (AS) manifests with a broad spectrum of clinical features in pediatric populations. Diagnosis may be difficult in the absence of detectable numbers of eggs. As a result, new approaches may be required to achieve an accurate diagnosis. Optimal praziquantel (PZQ) treatment regimen for young children is debatable. Also, the post-treatment response is still poorly evaluated due to the lack of reliable markers. A group of 6 children (a toddler and 5 pre-school children) and one pre-adolescent were investigated for AS clinical manifestations and followed-up for two years after treatment. Ova detection was performed by Kato-Katz (KK) and presence of Schistosoma mansoni DNA was assessed by real-time PCR (rt-PCR) in stool samples. IgG and IgE anti-Schistosoma levels and urinary antigen were detected by ELISA and point-of-care circulating cathodic antigen (POC-CCA) testing in serum and urine, respectively. AS clinical symptoms were present in 5/7 (71.4%) of the infected children, and hypereosinophilia was detected in all of them. Ova detection and serology were positive in only 3/7 (44.9%) and 4/7 (57.1%), respectively. However, real-time PCR (rt-PCR) showed the presence of Schistosoma DNA in 6/7 (85.7%) of the cases, and urinary antigen was detected in all infected children. The long-term follow-up after treatment with three doses of PZQ (80mg/kg/dose), showed high cure rates (CR) as demonstrated by the DNA-based assay as well as reduced levels of side effects. CR based on urinary antigen detection ranged from 28.6 to 100%, being the highest CR due to double testing the 2-year post-treatment samples. The results suggest that high dose and repeated treatment with PZQ might be effective for AS in young children. Also, new laboratory markers should be considered to diagnosis and monitor the drug response.

Schistosomiasis in non-immune travellers can cause acute schistosomiasis, a multi-systemic hypersensitivity reaction. Little is known regarding acute schistosomiasis in children. We describe acute schistosomiasis in paediatric travellers and compare them with adult travellers.
A retrospective study of paediatric travellers (0-18 years old) diagnosed with schistosomiasis at Sheba Medical Center. Patients\' findings are compared with those of adult travellers from the same travel groups.
in total, 18 children and 24 adults from five different trips to Tanzania, Uganda, Nigeria and Laos were infected (90% of the exposed travellers). The median bathing time of the infected children was 30 min (interquartile range (IQR) 15-30 min). The most common presentations were respiratory symptoms in 13 (72%), eosinophilia in 13 (72%) and fever in 11 (61%). Acute illness included a median of 2.5 symptoms. Three children required hospitalization and three were asymptomatic. Fatigue was significantly less common in children compared with similarly exposed adults (33% vs 71%, P = 0.03). Rates of hospitalization and steroid treatment were similar. The median eosinophil count in children was 1045 cells/μl (IQR 625-2575), lower than adults [2900 cells/μl (IQR 1170-4584)], P = 0.02.
Children may develop acute schistosomiasis following short exposure to contaminated freshwater, demonstrating a high infection rate. Severity seems to be similar to adults, although children report fatigue less commonly and show lower eosinophil counts. The disease should be suspected in children with multi-systemic illness and in asymptomatic children with relevant travel history.

Acute schistosomiasis is a clinical type of schistosomiasis with severe symptoms. The number of acute schistosomiasis cases is not only a sensitive indicator to assess the endemic situation and control effects, but also an important indicator to define schistosomiasis outbreaks and evaluate the achievements of infection control or transmission control. Acute schistosomiasis control is therefore of great significance to achieve the goal of schistosomiasis elimination in China. This paper analyzes the features and causes of acute schistosomiasis, and proposes some suggestions for future acute schistosomiasis control in China.
［摘要］ 急性血吸虫病是一种临床病情较重的血吸虫病。急性血吸虫病发病人数是评估一个地区血吸虫病疫情态势和防治效果的敏感指标, 也是判定“突发疫情”、评价是否达到疫情控制或传播控制标准的重要指标。因此, 做好急性血吸虫病防控工作, 对我国既定血防目标的实现具有重要意义。本文分析了当前我国急性血吸虫病的发病特征及其发生原因, 并就今后做好急性血吸虫病防控工作的策略和措施提出了建议。.

This paper reports the diagnosis and treatment of 2 cases of acute schistosomiasis with ectopic lesion in the lung. It suggests that in schistosomiasis endemic areas, if the patients with the contact history of infested water have the symptom of fever, while the effects of anti-infection and the corresponding treatments are not good, the clinician should consider acute schistosomiasis.
［摘要］本文报道了2例肺部异位损害的急性血吸虫病患者的诊治经过。提示在血吸虫病流行区, 对有疫水接触史者出现发热症状, 抗感染及相应治疗效果不佳时要考虑急性血吸虫病。 ［关键词］急性血吸虫病; 异位损害; 肺部; 误诊; 类赫氏反应.

OBJECTIVE: To analyze the antibody titer value of indirect haemagglutination test (IHA) in 135 confirmed acute schistosomiasis patients, so as to provide the evidence for improving the diagnosis and treatment of acute schistosomiasis.
METHODS: A total of 135 acute schistosomiasis inpatients were selected from 2001 to 2006. They all received the IHA antibody titer detection, and the correlation among the age, incubation period, and hospitalization days was calculated.
RESULTS: The antibody titers of IHA were higher than 1:320 in all the cases. The percentages of 1:640, 1:1 280, 1:2 560, 1:5 120 and 1:10 240 were 1.48%, 28.15%, 35.56%, 20.00%, and 14.81% respectively. The mean age was (47.70 ± 14.58) years, average incubation period was (38.03 ± 4.59) days and mean hospital stay time was (15.08 ± 3.79) days. The antibody titer value had no correlation with the age distribution (r = 0.109, P > 0.05). There was a negatively correlation between the antibody titer value and incubation period, (r = -0.558, P <0.01), there was a positive correlation between the antibody titer value and hospitalization time (r = 0.791, P < 0.01), and there were significant differences among different groups (F = 17.07, 64.53, both P < 0.01).
CONCLUSIONS: The antibody titer of acute schistosomiasis cases detected by IHA is 1:640 and above. There is no correlation between the antibody titer value and age, but the antibody titer value is higher, the incubation period is shorter and hospitalization time is longer.
［摘要］目的 分析急性血吸虫病确诊病例间接血凝试验 (IHA) 检测抗体滴度效价, 为诊断与治疗急性血吸虫病提供 依据。方法 以2001年以来收治住院的135例急性血吸虫病确诊病例为观察对象。采集病人基本情况, 询问疫水接触 情况等, 并进行IHA抗体滴度效价检测, 比较不同年龄、潜伏期与住院天数之间的相关性。结果 135例病例中IHA检测 抗体滴度均> 1∶320, 其中滴度1∶640、1∶1 280、1∶2 560、1∶5 120、1∶10 240 分别占1.48%、28.15%、35.56%、20.00%、 14.81%。急性感染病例的平均年龄47.70 ± 14.58岁, 平均潜伏期38.03 ± 4.59 d, 平均住院时间15.08 ± 3.79 d。抗体滴度 效价与年龄分布无相关性 (r = 0.109, P > 0.05), 差异无统计学意义 (F = 0.64, P > 0.05), 但与潜伏期呈负相关 (r = -0.558, P < 0.01) 、住院时间呈正相关 (r = 0.791, P < 0.01), 各组差异均有统计学意义 (F = 17.07、64.53, P 均< 0.01) 。结论 IHA 检测急性血吸虫病例抗体滴度效价均在1∶640及以上, 抗体滴度效价与年龄大小无相关性, 抗体滴度效价高者, 血吸虫 病潜伏期短、住院时间长。.