All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Schistosomiasis - Diagnosis
Medical expert of the article
Last reviewed: 03.07.2025
In the acute period of the disease, the diagnosis of schistosomiasis takes into account the epidemiological history and the presence of signs of “cercarial dermatitis” after swimming in contaminated bodies of water.
Urine is examined after centrifugation, keeping in mind that the maximum number of eggs is excreted with urine between 10 a.m. and 2 p.m. Invasion is assessed as intensive when the number of S. haematobium eggs is more than 50 in 10 ml of urine and more than 100 S. mansoni, S. japonicum, S. intercalatum and S. mekongi eggs in 1 g of feces. Schistosome eggs in feces are detected using various methods of coproovoscopy: examination of a native smear (ineffective), sedimentation after dilution of feces, preparation of smears according to Kato-Katz, etc. The tests must be repeated many times, especially in cases of chronic course and development of fibrous changes in the intestine.
Cystoscopy makes it possible to detect changes in the bladder mucosa that are specific to urogenital schistosomiasis: granulomas, "sand spots", black microgranulations, infiltrates. A valuable addition to cystoscopy is endobiopsy. Contrast urography reveals changes in the structure of the ureters. Survey radiography reveals changes in the lungs, calcification of the bladder walls. Fibrocolonoscopy (with endobiopsy), ultrasound of the abdominal cavity and pelvic organs, etc. are also used to detect organ and functional disorders.
[ Indications for consultation with other specialists
Diagnosis of schistosomiasis is supplemented by consultations with a proctologist in case of complicated intestinal schistosomiasis; a urologist in case of complicated urogenital schistosomiasis; a hepatologist in case of liver damage; a cardiologist in case of signs of "pulmonary" heart.
Differential diagnosis of schistosomiasis
Differential diagnostics of schistosomiasis is carried out with acute intestinal infectious diseases, typhoid-paratyphoid diseases, visceral leishmaniasis, serum sickness, and in case of pronounced eosinophilia - with the migratory phase of other helminthiases (strongyloidiasis, filariasis, etc.). Intestinal forms of schistosomiasis must be differentiated from amoebiasis, shigellosis, chronic colitis, liver cirrhosis of viral and other origin; urogenital schistosomiasis - from various diseases of the genitourinary system, including inflammatory diseases, tuberculosis and cancer of the urinary tract. However, diagnostics becomes easy after the appearance of eggs in the urine (S. haematobium) and feces (S. mansoni, S. japonicum. S. mekongi, S. interсalatum).