Clinical management of acute schistosomiasis: still challenging!

摘要

The diagnosis of AS remains difficult, although molecular tools may be helpful as illustrated during one of the reported outbreaks.1 Clinically, the association of fever, angioedema, dry cough, urticaria and high blood eosinophilia clearly points to an allergic reaction to the migrating and maturing helminth larvae such as in AS.4 Diagnosis during this very early phase of the parasitic lifecycle classically relies on serological testing. The sensitivity and specificity of serological tests for AS diagnosis reach 80 and 97%, respectively when a combination of ELISA and indirect hemagglutination assays are used.3 However, following exposure, the median time to seroconversion is about 46 days, whereas clinical signs appear after about 30 days and ranges can be broad (1-12 wk).