How is intestinal and liver schistosomiasis (bilharzia) diagnosed?

Updated: Jun 11, 2020
  • Author: Shadab Hussain Ahmed, MD, AAHIVS, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Points to consider in testing for intestinal and liver schistosomiasis include the following:

  • Direct stool examination is not a sensitive test for intestinal and liver schistosomiasis (both of which occur in chronic disease)

  • Concentration techniques, such as a Kato-Katz thick smear, are needed; this demonstrates the number of eggs excreted per day

  • Blood in the stool should be ruled out

  • Tests should include a CBC for anemia and eosinophilia

  • Thrombocytopenia is secondary to splenic sequestration

  • Additional testing for HIV and HPV should be considered in female genital schistosomiasis

  • Diagnostic tests for hepatitis B and C should be considered in liver schistosomiasis

Liver function test results usually are within the reference range until the end stage of disease. Mild elevation of alkaline phosphatase and gamma-glutamyl transferase levels may occur. If liver function test results are abnormal, look for other co-infections or diseases.

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