Pulmonary nodules in African migrants caused by chronic schistosomiasis

Lancet Infect Dis. 2017 May;17(5):e159-e165. doi: 10.1016/S1473-3099(16)30530-8. Epub 2017 Feb 15.

Abstract

Schistosomiasis is a neglected tropical disease that can cause mainly hepatic and genitourinary damage, depending on the species. Involvement of the lungs has been commonly described in acute infection (Katayama syndrome) and chronic infection (pulmonary hypertension). Although rarely reported in the scientific literature, cases of lung nodules due to chronic schistosome infection are also possible and are probably more frequent than commonly thought. Here we report seven cases of African migrants who were diagnosed with chronic schistosomiasis and pulmonary nodules due to deposition of schistosome eggs, and we compare our findings to the case reports found in the scientific literature. We discuss the management of these patients in a non-endemic setting, beginning with a first fundamental step that is to include parasitic infections, namely schistosomiasis, in the differential diagnosis of pulmonary nodules in African immigrants. All patients responded to antiparasitic treatment with praziquantel after a relatively short time. We therefore conclude that lung biopsies and other invasive procedures (performed in the first cases to rule out other potential causes, such as tuberculosis or malignant nodules) can be avoided or postponed.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Chronic Disease
  • Humans
  • Italy
  • Lung / pathology
  • Lung Diseases, Parasitic / drug therapy
  • Lung Diseases, Parasitic / parasitology
  • Male
  • Praziquantel / therapeutic use*
  • Schistosoma haematobium / isolation & purification
  • Schistosomiasis haematobia / diagnosis*
  • Schistosomiasis haematobia / drug therapy*
  • Schistosomiasis haematobia / parasitology
  • Tomography, X-Ray Computed
  • Transients and Migrants*

Substances

  • Praziquantel