How to treat schistosomiasis infection?

Question

Hi doctor,

My brother got infected with Schistosoma this year after having a trip. This morning, he had a worm in the toilet bowl which was approximately three meters long. My family members are not using the toilet and our cat uses the toilet sometimes. Please suggest.

Answer 1

Hi,

Welcome to icliniq.com.

I encourage you to upload more photos (attachment removed to protect patient identity) which helps us to diagnose the worm. Adult worms usually live with a size of three meters long. But there are certain liver flukes namely clonorchis sinensis and fasciola species which appears similar to schistosomiasis.

To differentiate them, it is necessary to do a stool examination for the ova and parasites. There is no harm to give some empirical antiparasitic medication to treat the infection. Kindly mention the age of your brother and his weight. Because medications are given according to the weight-based regimen.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

No, the video is not uploadable. You should get him tested for active or past infection. Sometimes past infections cause excretion of eggs and adult worms without causing infection. It is necessary to test antibodies against schistosomiasis by ELISA (enzyme-linked immunosorbent assay), 24-hour stool collection for diagnosing adult worms and eggs, and for quantification of the parasite load.

It is necessary to do a stool examination for schistosomal antigen. Kindly share the reports after doing these tests. You can give him Praziquantel 1500 mg twice daily for a day. If there is an infection, then it is good to meet a general practitioner soon.

Thank you.