Vol 58, No 1-4 (2007)
TROPICAL MEDICINE
Submitted: 2013-02-18
Published online: 2010-03-26
Difficulties in the diagnosis of schistosomiasis in patients of the Departament of Tropical and Parasitic Diseases of the MUG
Jolanta Goljan, Wacław Leszek Nahorski, Iwona Felczak-Korzybska, Agnieszka Wroczyńska, Przemysław Myjak, Andrzej Kotłowski
IMH 2007;58(1-4):157-165.
Vol 58, No 1-4 (2007)
TROPICAL MEDICINE
Submitted: 2013-02-18
Published online: 2010-03-26
Abstract
Between 2002 and 2006 in the Department of Tropical and Parasitic Diseases of the
Medical University of Gdansk 40 hospitalized patients were suspected of
schistosomiasis on the basis of clinical manifestations, epidemiological data and
positive serology tests (ELISA IgG).
In spite of multiple tests, schistosoma eggs were not identified neither in stool nor
in urine of the patients.
Histopathological examinations of liver and colon or bladder mucosal biopsy have
not revealed schistosoma eggs in chosen patients.
Diagnosis confirmation in case of negative parasitic tests requires serologic tests for
schistosomiasis. ELISA serology tests for antibodies class G were performed in all 40
patients. In some cases the results were dubious – index in the upper limit or only
slightly elevated. In those cases, cross reactions with Plasmodium spp. were taken into
account. In 10 patients, serologic index for schistosomiasis was elevated during or a few
weeks after treatment for malaria. In control tests, 4-8 weeks after the first examination, serologic indexes for schistosomiasis were significantly lower or normal without
specific treatment with praziquantel (Biltricide, Cesol). Seven patients were lost from
follow up.
Because of diagnostic difficulties confirmation tests with Immuno-Blot IgG were
introduced to verify ELISA. After final clinical and serologic analysis, human
schistosomiasis was diagnosed in 23 patients who were treated with success.
Abstract
Between 2002 and 2006 in the Department of Tropical and Parasitic Diseases of the
Medical University of Gdansk 40 hospitalized patients were suspected of
schistosomiasis on the basis of clinical manifestations, epidemiological data and
positive serology tests (ELISA IgG).
In spite of multiple tests, schistosoma eggs were not identified neither in stool nor
in urine of the patients.
Histopathological examinations of liver and colon or bladder mucosal biopsy have
not revealed schistosoma eggs in chosen patients.
Diagnosis confirmation in case of negative parasitic tests requires serologic tests for
schistosomiasis. ELISA serology tests for antibodies class G were performed in all 40
patients. In some cases the results were dubious – index in the upper limit or only
slightly elevated. In those cases, cross reactions with Plasmodium spp. were taken into
account. In 10 patients, serologic index for schistosomiasis was elevated during or a few
weeks after treatment for malaria. In control tests, 4-8 weeks after the first examination, serologic indexes for schistosomiasis were significantly lower or normal without
specific treatment with praziquantel (Biltricide, Cesol). Seven patients were lost from
follow up.
Because of diagnostic difficulties confirmation tests with Immuno-Blot IgG were
introduced to verify ELISA. After final clinical and serologic analysis, human
schistosomiasis was diagnosed in 23 patients who were treated with success.
Title
Difficulties in the diagnosis of schistosomiasis in patients of the Departament of Tropical and Parasitic Diseases of the MUG
Journal
International Maritime Health
Issue
Vol 58, No 1-4 (2007)
Pages
157-165
Published online
2010-03-26
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Bibliographic record
IMH 2007;58(1-4):157-165.
Authors
Jolanta Goljan
Wacław Leszek Nahorski
Iwona Felczak-Korzybska
Agnieszka Wroczyńska
Przemysław Myjak
Andrzej Kotłowski
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