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Acute schistosoma mansoni infection in the liver
Journal of Hepatology 35 (2001) 147
www.elsevier.com/locate/jhep
Images in Hepatology
Acute schistosoma mansoni infection in the liver
A 55-year-old Japanese man, previously healthy, presented with general fatigue and high-grade fever 4 weeks after returning from Kenya. Physical examination was unremarkable. Laboratory analyses demonstrated no abnormality except for prominent eosinophilia (4:4 £ 10 3 cells/mm 3) and a high erythrocyte sedimentation rate (57 mm/h). No parasites or eggs was not seen in the faeces on admission. Abdominal ultrasonography revealed no abnormality. Laparoscopy demonstrated numerous whitish±yellow lesions (egg-nodules) on the surface of the liver (left panel: view of right lobe of liver) and on the peritoneum. Needle biopsy of a lesion disclosed eggs with granulomas in the portal area (right panel). Repeated stool examinations revealed eggs of schistosoma mansoni characterized by a prominent lateral spine. Praziquantel (60 mg/kg) relieved his symptoms within a week. Early diagnosis is sometimes dif®cult because the majority of patients with acute schistosomiasis present with non-speci®c symptoms and eggs appear in the faeces only 8±10 weeks after infection. Laparoscopy, therefore, can be useful in early diagnosis. Schistosomiasis mansoni infection should be considered as a differential diagnosis for all travellers returning from endemic areas with fever of unknown origin. Kazumoto Murata, Katsuya Shiraki First Department of Internal Medicine, Mie University School of Medicine, Tsu, Mie 514-8507, Japan
0168-8278/01/$20.00 q 2001 European Association for the Study of the Liver. Published by Elsevier Science B.V. All rights reserved. PII: S 0168-827 8(01)00086-1
www.elsevier.com/locate/jhep
Images in Hepatology
Acute schistosoma mansoni infection in the liver
A 55-year-old Japanese man, previously healthy, presented with general fatigue and high-grade fever 4 weeks after returning from Kenya. Physical examination was unremarkable. Laboratory analyses demonstrated no abnormality except for prominent eosinophilia (4:4 £ 10 3 cells/mm 3) and a high erythrocyte sedimentation rate (57 mm/h). No parasites or eggs was not seen in the faeces on admission. Abdominal ultrasonography revealed no abnormality. Laparoscopy demonstrated numerous whitish±yellow lesions (egg-nodules) on the surface of the liver (left panel: view of right lobe of liver) and on the peritoneum. Needle biopsy of a lesion disclosed eggs with granulomas in the portal area (right panel). Repeated stool examinations revealed eggs of schistosoma mansoni characterized by a prominent lateral spine. Praziquantel (60 mg/kg) relieved his symptoms within a week. Early diagnosis is sometimes dif®cult because the majority of patients with acute schistosomiasis present with non-speci®c symptoms and eggs appear in the faeces only 8±10 weeks after infection. Laparoscopy, therefore, can be useful in early diagnosis. Schistosomiasis mansoni infection should be considered as a differential diagnosis for all travellers returning from endemic areas with fever of unknown origin. Kazumoto Murata, Katsuya Shiraki First Department of Internal Medicine, Mie University School of Medicine, Tsu, Mie 514-8507, Japan
0168-8278/01/$20.00 q 2001 European Association for the Study of the Liver. Published by Elsevier Science B.V. All rights reserved. PII: S 0168-827 8(01)00086-1