Which procedures are used in the diagnosis of schistosomiasis (bilharzia)?

Updated: Jun 11, 2020
  • Author: Shadab Hussain Ahmed, MD, AAHIVS, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Procedures used in the diagnosis of schistosomiasis include the following:

  • Sigmoidoscopy/proctoscopy - Can be used to obtain mucosal biopsies (including rectal) for diagnosis and to identify complications such as pedunculated and sessile polyps

  • Cystoscopy - Cystoscopy may be useful in schistosomiasis with primary bladder involvement for definitive diagnosis or to evaluate secondary ulcers and polyps, to biopsy for malignancy, to rule out other sources of hematuria and dysuria, and to identify eggs in mucosal biopsy specimens

  • Surgical biopsy - Findings may be used to diagnose ectopic schistosomiasis

  • Bronchoscopic washings or transbronchial biopsies - Eggs can be detected in individuals with pulmonary involvement [55, 56]

  • Lumbar puncture - Eosinophils may be present in the cerebrospinal fluid (CSF) of individuals with neurologic involvement. One review showed that 41% of individuals with spinal cord involvement had eosinophils present in their CSF; 85% of these patients also had antischistosomal antibodies detected in spinal fluid. [57]

  • Upper endoscopy - Can assess for esophageal varices; treat upper intestinal bleeding with endoscopic sclerotherapy

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