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bilharziasis

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Def:  Infective parasitic granuloma which is endemic in Egypt. Mode of infection:  Cercariae in water penetrate skin reaching capillaries and circulate with venous blood to reach lungs and final habitat (Portal Veins). Most of deposited ova in bladder & rectum escape outside with urine & stools.  Ova appear oval or rounded, red with eosin stain (living ova) or dark blue (dead ova with dystrophic calcification).  Cellular infiltration around ova may be: i. Focal: (Bilharzial nodule, pseudo-tubercle or bilharzioma). ii. Diffuse reaction.  Cellular reaction around ova is replaced by fibrosis.   Granuloma rich in esinophils.  Due to heavy deposition of ova. Heals by fibrosis & calcification. Complications of intestinal bilharziasis: 1) Recurrent bleeding per rectum (hematochezia) → anemia. 2) Secondary infection  dysentery. 3) Bilharzioma: Bilharzial pericolitis. → granulomatous mass called (Pericolic mass) mistaken for tumor. 4) Disimpacted ova pass with portal blood as emboli to liver  deposited in portal tracts  Bilharzial hepatic fibrosis. Complications of Bilharzial Cystitis: 1. Hematuria → microcytic hypochromic anemia. 2. Secondary bacterial infection of bladder wall and perivesical tissue. 3. Fistula between bladder and surroundings . 4. Stone formation: ova, epithelial debris and alkalinity of urine form nucleus for phosphate stone that helped by infection. 5. Bladder fibrosis, bladder neck obstruction, dilatatio ...
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