Cases reported "schistosomiasis japonica"

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1/25. Hepatic calcification by sequelae of chronic schistosomiasis japonica: report of four cases.

    Due to the elimination of intermediate hosts and the improvement of clinical care, most parasitic infections have been effectively controlled in developing countries. Recently, the increase of the worldwide tourism, especially to Mainland china, and the migration of overseas workers from endemic countries have led to more parasitic infections that should not be overlooked by physicians. Assessment of diffuse liver disease with physical examination and laboratory findings is notoriously inaccurate. Thus, physicians use liver biopsy for accurate diagnoses. We present 4 patients with hepatic schistosomiasis japonica which were diagnosed using imaging before liver biopsy. Hepatic schistosomiais japonica has a tendency to cause dystrophic calcification and fibrosis in the liver. According to the results, a combination of ultrasonography and computed tomography (CT), used to recognize characteristic calcification patterns, seem useful to physicians for accurate diagnoses. Thus, unnecessary biopsy procedures can be avoided. ( info)

2/25. Possible associations of rectal carcinoma with schistosoma japonicum infection and membranous nephropathy: a case report with a review.

    We report the first case of rectal carcinoma associated with S. japonicum and membranous nephropathy. A 57-year-old Japanese man noticed narrowing of his feces. He had lived in Yamanashi prefecture, an endemic area of S. japonicum. He had suffered from nephrotic syndrome for about 1 year. barium enema study showed a severe stricture in the upper rectum and biopsy specimens from the tumor demonstrated well differentiated adenocarcinoma and many ova of S. japonicum. Sonography of the liver showed a network pattern and a linear high echoic area. Low anterior resection with incisional biopsy of the liver and the right kidney was performed. Histopathological findings showed well differentiated adenocarcinoma and schistosomal ova. The total number of ova in the resected colon amounted to 15,133, consisting of 2243 inside and 12,890 outside the carcinoma. The nearer to the carcinoma the area was, the higher was the density of ova. The findings of light microscopy and electron microscopy of the biopsy specimen from the kidney were compatible with membranous nephropathy (stage II). This case suggests that schistosomal ova have some effect on carcinogenesis and nephrotic syndrome. In patients with nephrotic syndrome of unknown cause, especially in inhabitants of endemic areas of S. japonicum, gastrointestinal malignancy should be ruled out as an etiological factor. sigmoidoscopy would be useful for colorectal carcinoma surveillance in S. japonicum patients. ( info)

3/25. schistosoma japonicum infection presenting with colon perforation: case report.

    Colon perforation can be caused by a variety of entities, including iatrogenic trauma, tumors, ischemia, inflammatory bowel disease, and steroid use. Parasitic infection rarely leads to colon perforation. Secondary peritonitis results from mixed microorganism infection, including enterococci, enteric bacilli, and anaerobes. A combination of an optimal antibiotic regimen and surgical intervention is of paramount importance. Nevertheless, intra-abdominal infections usually have a high mortality rate. Schistosomiasis occurs worldwide. S. japonicum infection is endemic in asia. The most common complications of gastrointestinal schistosomiasis are periportal fibrosis, intestinal polyposis, and bowel stricture. Rarely, schistosomiasis results in colon perforation. The diagnosis of schistosome infections is based on ova in stool or tissue specimens, and/or immunologic diagnostic tests. The most effective anti-schistosomiasis agent is praziquantel. Herein, we describe an unusual case of colon perforation associated with schistosoma japonicum infection, which resulted in severe peritonitis and led to the patient's death. ( info)

4/25. Schistosomiasis of the ovary with endometriosis and corpus hemorrhagicum: a case report.

    We present a case of Schistosomiasis of the ovary associated with endometriosis and corpus hemorrhagicum. This association has not been reported previously. A 31-year-old Filipino woman visited Li Shin Hospital because of several weeks' history of lower abdominal pain. An ultrasound study revealed a right ovarian mass, and a right oophorectomy was performed. The gross findings included a corpus hemorrhagicum and endometriosis. The histopathologic findings revealed schistosoma japonicum eggs in the fibrous wall of the ovary with evidence of a chronic inflammatory response containing eosinophils. After a second surgery and medical treatment with antiparasitic drugs, her symptoms were relieved. Adhesions resulting from the oophorectomy and endometriosis of the ovary had resulted in alteration of the blood channels and contributed to the aberrant spread of the Schistosoma eggs. The migration of overseas workers from endemic countries and the growing popularity of worldwide tourism may increase the incidence of parasitic infections. ( info)

5/25. Hepatic schistosomiasis japonica in a patient with gallstones and bile duct stones--a case report.

    Schistosomiasis, a common parasitic disease in many countries, is found as imported cases in taiwan. Responsible for human infections are five species, one of which, schistosoma japonicum, is currently endemic in china and South-east asia. Chronic infection with S. japonicum may lead to the development of liver fibrosis, calcification and portal hypertension. Under investigation by sonography and computed tomography (CT) scan, a peculiar "turtle-back" appearance of liver fibrosis and calcification may be found. Herein, we report a case referred to our department due to jaundice. The sonography of liver showed typical "turtle-back" appearance. gallstones and bile duct stones were also found in this case. Surgical interventions with percutaneous transhepatic biliary drainage (PTBD), cholecystectomy and choledocholithotomy were performed to relieve the obstructive jaundice and remove the stones. There were no parasitic eggs in the extracted stones or in drained bile juice. However, deposits of calcified S. japonicum eggs in liver parenchyma and portal tracts were identified in liver biopsy. No special treatment was given for the schistosomiasis japonica because the calcified parasitic eggs were the sequelae of past infection. ( info)

6/25. Proximal tubal obstruction associated with tubal schistosomiasis.

    The gynecologic consequences of schistosomiasis may range from minimal inflammation of tubal serosa to more intense reactions involving the periadnexal regions. Complete obliteration of the tubal lumen has not been described. We describe a case of proximal tubal obstruction associated with tubal schistosomiasis. ( info)

7/25. cholangiocarcinoma coincident with schistosomiasis japonica.

    The relationship of parasitic liver disease to cholangiocarcinoma has long been debated, and it has been reported that cholangiocarcinoma is associated with opisthorchiasis viverrini. We report herein a rare case of cholangiocarcinoma associated with schistosomiasis japonica. A 76-year-old Japanese man with jaundice was diagnosed with cholangiocarcinoma. Radical resection was not done because of hepatic arterial and portal vein invasion. Biliary microwave tissue coagulation therapy was performed with placement of a metallic stent endoprosthesis. Twenty-two months after the treatment, however, the patient died from hematemesis. autopsy findings revealed that there was no distant metastasis, even in the area of regional lymph node metastasis. The primary tumor in the hepatic hilar region had been replaced by necrotic debris resulting from the microwave therapy, and an expandable metallic stent was located in the center of the debris. Histological findings showed schistosome eggs, which were old and microcalcified, in veins in the colonic submucosa. Glisson's fibrosis around the cancer lesion suggested that schistosomiasis japonica and cholangiocarcinoma can occur together with severe chronic inflammation of the portal vein. ( info)

8/25. Determination of the period for establishment of a liver network echogenic pattern in schistosoma japonicum infection.

    Schistosomiasis is caused by infection with schistosoma haematobium, S. mansoni, S. japonicum, or S. mekongi. S. japonicum infection results in liver cirrhosis at the final stage. A "network" (NW) echogenic pattern on hepatic ultrasonography appears to be specific to S. japonicum infection. The principal aim of the present study was to determine the exact year(s) or even month(s) required for the establishment of the liver NW echogenic pattern from the initial infection in young patients with schistosomiasis japonica since there are few data on this important point. We conducted yearly ultrasonographic, serologic, coprologic, and physical examinations of schistosomiasis patients in the philippines from 1996 up to the present. During that period, the total number of patients examined was approximately 2,000, among whom we selected 2 patients for determination of the duration required for NW establishment, when they were 10 years old. Although the exact time of initial exposure to schistosomes cannot be determined, the duration for the establishment of NW was definitively confirmed in patient no. 1 to be between 19-24 months based on the results of serologic and coprologic examinations. For patient no. 2, the circumstantial evidence suggested that the establishment of a NW might require 5 to 6 years at maximum. To the best of our knowledge, this is the first evidence-based report on the determination of the period required for the establishment of a liver NW echogenic pattern in S. japonicum infection in the philippines. ( info)

9/25. Sigmoid colonic carcinoma associated with deposited ova of schistosoma japonicum: a case report.

    We report a case of sigmoid colonic carcinoma associated with deposited ova of schistosoma japonicum. A 57-year old woman presented with a 10-mo history of left lower quadrant abdominal pain and a 2-mo history of bloody stools. She had a significant past medical history of asymptomatic schistosomiasis japonica and constipation. A colonoscopy showed an exophytic fragile neoplasm with an ulcerating surface in the sigmoid colon. During the radical operative procedure, we noted the partially encircling tumor was located in the distal sigmoid colon, and extended into the serosa. Succeeding pathological analysis demonstrated the diagnosis of sigmoid colonic ulcerative tubular adenocarcinoma, and showed deposited ova of schistosoma japonicum in both tumor lesions and mesenteric lymph nodes. Three days after surgery the patient returned to the normal bowel function with one defecation per day. These findings reveal that deposited schistosome ova play a possible role in the carcinogenesis of colorectal cancer. ( info)

10/25. A case of cutaneous squamous cell carcinoma associated with sporadic porphyria cutanea tarda due to liver disorder after schistosoma japonicum infection.

    A 56-year-old man suffered from cutaneous squamous cell carcinoma (cutaneous SCC) which occurred on a cutaneous lesion of sporadic porphyria cutanea tarda (sporadic PCT). His liver function decreased from the time he was infected with schistosoma japonicum at the age of 10. He drank a little alcohol. Erythematous maculae with blisters or erosions occurred on sun-exposed areas of his skin when he was 52. His urine continued to be red. After detailed examinations including liver biopsy, he was diagnosed as having sporadic PCT due to liver disorder after infection with schistosoma japonicum. At the age of 56, a small red papule arose on his right earlobe at the site of a sporadic PCT lesion. The papule rapidly enlarged with ulceration; this completely destroyed his right earlobe, which was covered with odoriferous yellow-white necrotic tissue. The tumor then extended to his right preauricular area with ulceration. A skin biopsy confirmed well-differentiated cutaneous SCC. The association of cutaneous SCC with sporadic PCT has not been previously reported; we think that the association is significant. Such an occurrence may have been induced by either direct or indirect effects of ultraviolet light or a scar formed by the sporadic PCT. ( info)
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