• PREVALENCE OF SCHISTOSOMIASIS AS REPORTED BY THE STATION
__________________________________________
Prevalence (%)
No. of Overall
Persons S. Haema- S.Man- Preva Station Examined tobium soni lence+
____________________________________________
Al Baha 20.142 -- 13.0 13.0
Jizan 30.883 7.0 1.2 8.2
Taif 39.559 0.2 7.7 7.9
Abha 23.013 1.7 4.9 6.6
Madinah 17.591 1.9 3.6 5.5
Prevalence (%)
No. of OverallPersons S. Haema- S.Man- Preva
Station Examined tobium soni lence+____________________________________________
Bisha 16.766 0.4 8.5 8.9Najran 8.820 1.6 9.9 11.5Mahael 5.783 7.6 --- 7.6Hayil 4.335 --- 14.2 12.2Riyadh 15.129 --- 5.6 5.6Makkah 25.894 2.5 3.0 5.5Al-Jouf 12.577 1.3 1.6 2.9
Portal Vein
RectalInf. Mesentery
S P
KATAYAMA FEVER(KATAYAMA River, Japan)
1. SEVERAL DAYS – 2-3 WEEKS
2. FEVER, CHILLS, HEADACHE, MALAISE, EDEMA, CONFUSION
3. HEPATOSPLENOMEGALLY
4. LYMPHADENOPATHY
5. EOSINOPHILIA
6. CEREBRAL EDEMA (CT)
S. MANSONI (SYMPTOMS)SYMPTOM CASES
Abdominal Pain 258
Fatigue 221
Blood in Stool 205
Mucous in Stool 191
Tenesmus 121
Depression 108
Diarrhea 54
1Constipation 1
Oes. varices
Communication with
Systemic Circulation
Pulmonary Artery
BOTH (MANSONI & Haema.)
SYMPTOMS
Haematuria - 11
Abdominal Pain - 7
Tiredness - 7
Frequency - 6
Depression - 4
Tenesmus - 4
Blood in Stool - 3
Mucous in Stool - 3
U SCHISTOSOMIASIS
Kidney
U. Bladder
SIDE EFFECTS OF ANTISCHISTOSOMAL DRUGS (%)
METRIFONATE OXAMNIQUINE PRAZIQUANTEL SYMPTOMS
40 30 56 NONE
10 36 20 DIZZINESS
12 25 12 ABDOMINAL PAIN
10 12 10 JOINT PAIN
6 10 8 NAUSIA
2 4 6 RASH
SIDE EFFECTS OF ANTISCHISTOSOMAL DRUGS (%)
8 10 6 VOMITING
- 10 6 ITCHING
8 12 2 FATIGUE
- - 2 HAIRFALL
2 2 1 CHANGE IN TASTE
4 2 1 DIARRHEA
- 1 - CONVULSION
LEISHMANIASIS
It is the result of the infection with one of or other species of protozoa (leishmania). Conveyed by:
Sandflies (Phlebotomus).
Visceral Leishmaniasis: L. donovani
Mucocutaneous : L. Braziliensis
Cutaneous : L. tropica major L. tropica minor
New World : L. Braziliensis L. Mexicana
Oldworld
PATHOLOGY
» L. donovani parasitizes the reticu. endoth. cells
» Great proliferation of macrophage
» Cells result: Liver – spleen enlarg.
» The red bone marrow extend.
»
CLINICAL PICTURE•Incubation : 2 weeks – 18 months
early stages is not easy for diagnose. There is no constant physical signs.
BP , Pulse , - Fever
☺ Changes in the blood picture particularly Leucopenia.☺ Outstanding physical sign is the enlargement of the spleen 3 cm. a month.
● Liver : enlarged spleen + liver are neither tender nor painful.
● Sometimes: Jaundice = prognost. Significance
● Enlarged : Lymph node, could be but its not a feature of
the disease.
● Wasting : Emaciated pat with a protuberant
Abdomen ( liver + spleen enlarged)
●Fever : Without subjective symptoms of fever – no delirium.
● Sometimes: there is no fever
● Skin : dry, rough. The natural pigmentation of the skin over
the bone and around the mouth is deepened. (Kala azar??)
● Hair : fallout
● Lungs : Bronchopneumonia
● GIT : Diarrhea, dysentery
DIAGNOSIS1. Needle aspiration
Bone – sternum – liver, spleenHistology – cultureL. donovani body
2. a. Leucopenia: Neutropenia – relative mononucleosis.
b. Progressive fall with the red cell count
3. Formalin gel (aldehyde)
2 drops formalin + 2 ml serum
After 20 min, white ring
4. Complement fixation and fluorescentFalse positive trypanosomal infection
5. The complement fixation – early positive – negative after cure. Sometimes + or – lung. Other diseases.
6. Fluorescent antibody
7. IV + V: In trypanosomal infection
8. Skin test (Montenegro)Delayed hypersensitivity reaction
0.2 ml. suspension
PROPHYLAXISImmunity: Kala Azar permanent immunity
to all L. Donovani.• L. tropica major crass immunity to L.
tropica minor. Not the opposite.• L. brazillienses to L. mexican + but not vice
versa.
Vaccine: L. tropica major – living leptomonads.
L. donovani: Intradermally or s.c. local leishmanial infection. (Leichmanioma) Developing
immunity. No visceral L.
TREATMENT1. Antimonial –
i. Urea, stibamine, pentavalen + antmonyia
• I.V. daily or every 2 days
• 6 – 10 dose
• First 100 mg then 200 then 250
• Total dose 2 – 5 g. adult
Side Effect: Nausea, vomiting, joint pain, Abdominal pain, diarrhea
Contraindication: Liver and kidney failure
ii. Sodium stibogluconate (Pentostam)• I.M. – 600 mg total daily for 6-10 days• Repeated after 14 days; if needed• Side effect: Anaphylactic shock
2. Diamidiem – • Pentamidine isothionate• Dose 3 -4 mg / kg / BW total 300 mg
Side effect: Hypoglycemia
Top Related