hey everyone and this lesson were gonna talk about the schistosomiasis the
disease caused by the parasite Schistosoma and we're gonna talk about
what are some of the symptoms of schizophrenia and finally we're gonna
talk about how its treated so I begin what is schistosomiasis well again it is
a disease caused by an infection of a parasitic blood fluke or schistosomia
and this disease is also known as bilharziasis and it is estimated that
more than 200 million people worldwide are infected with schistosomiasis and
about 200,000 deaths are attributed to schistosomiasis per year and most
infected individuals are actually symptomatic now here's a picture of the
schistosomia parasitic blood fluke and individuals are infected with the blood
fluke in contaminated water so when individuals such as children adults wade
through the waters they can be infected by the schistosomia blood flukes now
there are five different species of Schistosoma blood fluke that can cause
Schistosomiasis and each has a different geographical range
the first one is Schistosoma mansoni and Schistosoma mansoni is located in Africa
Middle East Caribbean and South America the next one is Schistosoma japonicum
and Schistosoma japonicum is located in China Indonesia and the Philippines
another species is known as Schistosoma Mekongi and this species is found in
Cambodia another species is Schistosoma haematobium in this species is found in
Africa in the Middle East and this one in particular is involved in genital
urinary infection and the last one is Schistosoma intercalating in Schistosoma
intercalated is found in the Congo Gabon and Cameroon so here is a diagram from
the CDC on the lifecycle of Schistosoma so if we start at the egg stage the eggs
can be carried in the feces and urine from
infected individuals and these eggs can be released into water and in hatched
into what we call miracidia. Miracidia can then penetrate into snail
tissue so the miracidia can then penetrate into its intermediate host the
snail eventually what we call sporocysts begin to accumulate in the snail
and then cercariae are released from the snail and into the water and these
cercariae are free swimming and these are what can actually penetrate and they
can penetrate into the skin so when the person is walking through the water the
sarkari can enter and penetrate into the skin when the circular to penetrate into
the skin they lose their tail and become a Schistosoma lay the Schistosoma we can
then enter the circulation of the infected individual migrate to the
portal blood in the liver and then mature into adults whereby they the
adult worms can then migrate into the mesenteric venules of the bowel and
rectum they lay eggs and then these eggs can be shed in the stool and then into
some water source and then the cycle can begin again and that completes the life
cycle of the Schistosoma parasitic blood fluke so when an individual is infected
with a Schistosoma parasite what are some of the symptoms well in an acute
infection which typically occurs in travelers going to some of these
affected regions the individuals can get what we call a swimmers itch or an itchy
rash from the penetration of sir Kerry into the skin and it can look something
like this so you get this rash if you're been in contaminated waters and during
the acute period of infection we can see this syndrome known as acute
schizophrenia fever and this we'll talk about this in another lesson but this is
due to an immune reaction to these parasites and can
lead to a different subset of symptoms now most of the symptoms we talked about
in schistosomiasis is due to a chronic infection in the chronic infection is
due to an ongoing exposure of the parasites and they're produced eggs and
the disease severity itself is related to the number of eggs and a tissue
distribution of the parasites and the eggs now depending on how many eggs are
in the intestinal tract we can see different types of symptoms within the
intestinal tract some of them include a chronic or intermittent abdominal pain
these individuals can also experience poor appetite they can have diarrhea
they can have intestinal bleeding and the diarrhea intestinal bleeding can
lead to a iron deficiency anemia some of the other symptoms of schizophrenia
system so we've talked about how the worms can migrate to the portal system
of the liver and this can lead to several important symptoms in these
patients one is hepatomegaly so the liver enlarges in some of these patients
there can be perry portal fibrosis there can be portal hypertension the
portal hypertension is due to just an accumulation of these parasites within
the portal system leading to increase or buildup in the portal pressure and the
portal hypertension from the parasite burden can lead to splenomegaly due to a
backup of venous return back into the spleen leading to splenomegaly so we
call this a Patou splenic schistosomiasis another system that can
be infected is the genitourinary system and this can lead to a genitourinary
schistosomiasis and this genital urinary symptoms can be usually related to an
infection with Schistosoma haematobium and this can lead to infertility in some
patients it can lead to an increased risk for HIV infection
hematuria and it's important to realize that in these cases eggs can be also
excreted in the urine so the eggs can be released
leading to lesions and this is can be a reason why we see blood in the air in
hematuria and can also lead to increased risk of HIV infection another system
that can be infected is the pulmonary system and the parasite burden if they
are located within the pulmonary system it can lead to an increase in pressure
in the system leading to a pulmonary hypertension it can lead to a core
pulmonale can lead to dis me a can lead to cardiac enlargement and it can lead
to pulmonary arterial dilatation which is typically seen in the end stage
another system that can be affected is the nervous system and it can lead to
what we call neuro schistosomiasis and this is again due to the parasite burden
and it can lead to spinal cord lesions and it typically causes myelopathy more
so than cerebral disease but you can still see symptoms of cerebral disease
as well and other symptoms include anemia malnutrition growth retardation
and general disability and we've talked about some of the reasons why these
symptoms can occur as well so now that we know some of the symptoms of
schistosomiasis how can we definitively determine if it is schistosomiasis or not. That comes down to diagnosis of the schistosomiasis and
it so it's important to ask travelers in particular if what countries they've
traveled to if they've been into any of these affected regions and it's also
important to ask individuals from these countries if they've been wading through
any open waters and if they've had any rash or any of the other symptoms that
can fit with schistosomiasis but with diagnosis it's important to check
serology so look for antibodies that's particularly important in travelers it's
important to do a urine analysis we've talked about how some species can
release their eggs in the urine and it's important to do a PCR to check for
parasite genetics so it's important to check these for diagnostic criteria to
see if these individuals are in fact infected with Schism parasites and
once we have determined if it is a Schistosoma infection what are some of
the treatments well the treatment for schizophrenia or built reside so
praziquantel is actually anthelmintic or an antihelminthic anti against
helminthic it's against these parasitic worms so it is a drug that can kill
these parasitic worms and a dose of typically 20 milligrams per kilogram is
needed three times daily four to six hour intervals for one day would be the
treatment for these individuals so again the treatment for schistosomiasis and anti
helminthic and we give it to the patient at a twenty milligram per kilogram dose
and we give this dose three times a day in about four to six hour intervals for
one day and that is the treatment for schistosomiasis. Anyways guys that was a lesson on
schistosomiasis I hope you found this video helpful if you did please like and
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I'll see you next time