B65.1 Schistosomiasis due to Schistosoma mansoni [intestinal schistosomiasis]

Name of the Condition

• Schistosomiasis due to Schistosoma mansoni [intestinal schistosomiasis]

Summary

Schistosomiasis due to Schistosoma mansoni is a parasitic infection affecting the gastrointestinal tract. It is caused by the blood fluke Schistosoma mansoni and transmitted through contact with freshwater contaminated by the parasite’s larvae. The condition can lead to chronic inflammation, tissue damage, and complications if left untreated. Symptoms often involve intestinal and hepatic systems, with potential for long-term morbidity.

Causes

The infection is caused by Schistosoma mansoni, a parasitic flatworm. Larval forms (cercariae) penetrate the skin during contact with contaminated freshwater, where they mature into adult worms in the mesenteric veins. Adult worms release eggs that traverse the intestinal wall, causing inflammation and tissue damage. The lifecycle requires freshwater snails as intermediate hosts, which release infectious larvae into water sources.

Risk Factors

• Exposure to freshwater in endemic regions, particularly for activities like bathing, washing, or swimming.
• Residence in or travel to areas with poor sanitation and high prevalence of the disease.
• Occupational contact with contaminated water, such as farming or fishing.
• Lack of access to safe water and hygiene facilities.

Symptoms

• Abdominal pain, diarrhea, or blood in stool.
• Fatigue, fever, or weight loss.
• Hepatomegaly or splenomegaly (enlarged liver or spleen).
• Chronic cases may present with portal hypertension or liver fibrosis.

Diagnosis

Diagnosis typically involves detecting parasite eggs in stool or tissue samples. Serological tests may identify antibodies, while imaging (e.g., ultrasound) can assess organ involvement. Clinical history of exposure to contaminated water in endemic areas supports diagnosis.

Treatment Options

Treatment usually involves antiparasitic medications, such as praziquantel, to eliminate adult worms. Supportive care may address symptoms like pain or anemia. Severe cases with organ damage may require additional interventions, including management of complications like portal hypertension.

Prognosis and Follow-Up

With timely treatment, prognosis is generally good, though chronic infection can lead to irreversible organ damage. Follow-up may include monitoring for recurrence, assessing organ function, and addressing long-term complications. Regular screening may be recommended in endemic areas.

Complications

• Intestinal obstruction or perforation.
• Liver fibrosis or portal hypertension.
• Increased risk of colorectal cancer in chronic cases.
• Malnutrition or growth impairment in children.

Lifestyle & Prevention

• Avoid contact with freshwater in endemic regions.
• Use safe water sources for bathing, washing, or recreation.
• Improve sanitation and snail control in endemic areas.
• Educate communities on transmission risks and prevention strategies.

When to Seek Professional Help

Seek medical attention if experiencing persistent abdominal pain, blood in stool, unexplained weight loss, or signs of organ dysfunction (e.g., jaundice, ascites). Prompt evaluation is critical for early treatment and prevention of complications.

Tips for Medical Coders

Document the specific species (Schistosoma mansoni) and intestinal involvement to support accurate coding. Include details of exposure history, diagnostic findings, and treatment to clarify clinical context. Ensure documentation aligns with ICD-10-CM guidelines for specificity.