Last updated: Friday, 14, January, 2011
Key InformationAppropriate Tests

Swimmer's itch

'Swimmer's itch' ('Pelican itch') can be caused by schistosomes which do not cause systemic disease.

Testing is not required unless the patient has acquired symptoms after risk exposure in a geographical area known to be endemic for Schistosoma haematobium (Africa, the Middle East), S. mansoni (the Middle East, Africa, South America, the Carribbean), S. japonicum (Japan, China, the Philippines), S. mekongi (Southeast Asia) or S. intercalatum (West and Central Africa).

Acute schistosomiasis

The diagnosis is established by demonstration of eggs in urine or faeces.

FBC to detect eosinophilia; schistosome antibodies.

Follow up urine or stool examinations for viable eggs should be carried out for some weeks after treatment to ensure cure.

S. haematobium 

Eggs can be detected on microscopy of urine; the urine sample should be collected at the end of micturition.

Tissue biopsy (eg, bladder lesion) for diagnosis and to assess development of urothelial neoplasia.

  • Thickened bladder wall
  • Obstructive uropathy

S. mansoni, S. japonicum, S. mekongi 

Faeces - ova, cysts and parasites.

S. intercalatum

  • Abdominal pain
  • Blood in stools

Colorectal biopsy - see Rectal bleeding

  • Hepatosplenomegaly