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Parasitology

Schistosomiasis

 

Author: Nat Pernick, M.D., PathologyOutlines.com, Inc.

Last revised: 21 September 2012

 

Definition

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● Fluke that causes colitis or bowel obstruction

● Also known as bilharzia, bilharziosis or snail fever

 

Epidemiology

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● Associated with underdeveloped countries and living near dam reservoirs (Lancet Infect Dis 2006;6:411)

S. haematobium: Africa and Middle East; usually affects bladder; diagnosed with urine examination

S. intercalatum: central West Africa; uncommon

S. japonicum: Southeast Asia and western Pacific countries; diagnose with stool examination
S. mansoni:
South America, Caribbean, Africa and Middle East; diagnose with stool examination

S. mekongi: Southeast Asia; uncommon

 

Case reports

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● 31 year old woman with associated endometriosis (Fertil Steril 2006;85:1060.e1)

● 78 year old man with rectal adenocarcinoma (Univ Pittsburgh Case #199)

 

Gross images

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Schistosoma granulomas

 

Micro description

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Focal ulcers, eggs may be calcified, surrounded by fibrosis or granuloma

S. haematobium - eggs are 110-170 x 40-70 microns, oval with terminal spine
S. japonicum - eggs are 70-100 x 55-65 microns, oval/round (more rounded than other types), minute subterminal or no spine

S. mansoni - eggs are 110-175 by 45-70 microns with thin transparent shell and definite lateral spine

 

Micro images

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All subspecies

 

 

Schistosoma haematobium - oval eggs with terminal spine

 

Schistosoma haematobium Fluke

 

 

Schistosoma haematobium Eggs

 

 

Contributed by Drs. Kiran Alam, Anshu Jain, Veena Maheshwari, Farhan A. Siddiqui and Ershadul Haq, J.N. Medical College, India

Transitional epithelium of ureter Schistosome eggs in Schistosome eggs in

with Schistosoma haematobium submucosa muscle layer

eggs in submucosa and muscle

 

 

Schistosome eggs in muscle layer - note terminal spine

 

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Schistosoma japonicum - small eggs, more rounded, no / minute terminal spine

 

Schistosoma japonicum Eggs

fluke

 

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Schistosoma mansoni - lateral spine

 

Schistosoma mansoni fluke

 

 

Schistosoma mansoni eggs

 

 

Contributed by Dr. Jennifer Stumph, Spectrum Health, USA

 

37-year-old woman with S. mansoni eggs in colon biopsy

 

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Schistosoma images type not identified

 

Within tissue

 

 

Contributed by Dr. Lisa Cerilli

 

Within colonic mucosa

 

Other images: granuloma surrounding egg

 

Virtual slides - Schistosomiasis

 

References

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eMedicine #1, #2, Centers for Disease Control, Wikipedia, World Health Organization, Archives 2005;129:544 (S. mansoni)

 

End of Parasitology > Schistosomiasis

 

 

 

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