Schistosomiasis natural history, complications and prognosis

If left untreated, most of the patients with schistosomiasis may progress to develop ulceration or cancer of the bladder, liver or kidney failure. Common complications of schistosomiasis include hematuria, malnutrition, intestinal polyps, hydronephrosis, glomerulonephritis, bladder polyps, bladder cancer, infertility, ectopic pregnancy, renal failure, and cor-pulmonale. Depending on the extent of the disease progression at the time of diagnosis, the prognosis of schistosomiasis may vary. However, the prognosis is generally regarded as good with treatment.

If left untreated, most of the patients with schistosomiasis may progress to develop ulceration or cancer of the bladder, liver or kidney failure.^[1]

Common complications of schistosomiasis include:^[2][3]

• Hematuria
• Malnutrition
• Growth retardation
• Anemia of chronic disease
• Cervicitis
• Iron-deficiency anemia
• Splenomegaly
• Intestinal polyps
• Hydronephrosis
• Glomerulonephritis
• Recurrent Salmonella bacteremia
• Bladder polyps
• Bladder cancer
• Infertility
• Ectopic pregnancy
• Portal hypertension
• Esophageal varices
• Ascites
• Intestinal obstruction
• Obstructive uropathy
• Renal failure
• Generalized seizures
• Spinal cord compression
• Cor pulmonale

• Depending on the extent of the disease progression at the time of diagnosis, the prognosis of schistosomiasis may vary.
• Prognosis is good with treatment.
• The 1-year mortality rate of patients with schistosomiasis ranges approximately 0.1-11% depending upon underlying complications.
• If symptoms of schistosomiasis persists after 2 rounds of praziquantel treatment, more urine or stool samples should be taken and tested for viable parasite eggs, and re-treatment must be given if persistent infection is detected.^[4][5]