ICD-10: B65.2

Clinical Description of Schistosomiasis Due to Schistosoma japonicum (ICD-10 Code B65.2)

Overview of Schistosomiasis
Schistosomiasis is a parasitic disease caused by trematode worms of the genus Schistosoma. It is a significant public health concern in many tropical and subtropical regions, particularly in parts of Africa, the Middle East, Asia, and South America. The disease is characterized by a range of symptoms that can vary in severity depending on the species of Schistosoma involved and the extent of infection.

Specifics of Schistosoma japonicum
Schistosoma japonicum is one of the major species responsible for schistosomiasis, primarily affecting regions in East Asia, including China, the Philippines, and Indonesia. This species is known for its ability to cause severe disease and is associated with a higher risk of complications compared to other species, such as Schistosoma mansoni or Schistosoma haematobium.

Clinical Features

Symptoms
The clinical manifestations of schistosomiasis due to Schistosoma japonicum can be acute or chronic:

• Acute Phase: This phase may present with symptoms such as fever, chills, cough, and abdominal pain, often occurring after the initial exposure to the parasite. This is sometimes referred to as "Katayama syndrome," which is characterized by a hypersensitivity reaction to the eggs of the parasite.

• Chronic Phase: Chronic infection can lead to more severe complications, including:

• Intestinal Symptoms: Diarrhea, abdominal pain, and weight loss due to intestinal involvement.
• Hepatic Symptoms: Liver fibrosis, portal hypertension, and splenomegaly due to the accumulation of eggs in the liver.
• Neurological Symptoms: In rare cases, S. japonicum can cause neurological complications, including seizures and other central nervous system manifestations.

Diagnosis
Diagnosis of schistosomiasis typically involves a combination of clinical evaluation and laboratory tests. Key diagnostic methods include:

• Stool Examination: Microscopic examination of stool samples to identify eggs of S. japonicum.
• Serological Tests: Blood tests that detect antibodies against the parasite.
• Imaging Studies: Ultrasound or CT scans may be used to assess liver and intestinal involvement.

Epidemiology

Transmission
Schistosoma japonicum is transmitted through contact with freshwater bodies contaminated with the larvae (cercariae) released by infected freshwater snails. Human infection occurs when cercariae penetrate the skin during activities such as swimming or bathing in contaminated water.

Geographical Distribution
This species is predominantly found in East Asia, with significant prevalence in rural areas where agricultural practices involve irrigation and water management that create suitable habitats for the intermediate snail hosts.

Treatment

Antiparasitic Medications
The primary treatment for schistosomiasis due to S. japonicum is the administration of praziquantel, an effective antiparasitic medication that targets adult worms. Treatment regimens may vary based on the severity of the infection and the presence of complications.

Conclusion

ICD-10 code B65.2 specifically refers to schistosomiasis caused by Schistosoma japonicum, highlighting the need for awareness and appropriate management of this disease, particularly in endemic regions. Early diagnosis and treatment are crucial to prevent severe complications associated with chronic infection. Public health measures aimed at controlling snail populations and improving water sanitation are essential in reducing the incidence of schistosomiasis.

Schistosomiasis is a parasitic disease caused by trematode worms of the genus Schistosoma. Among the various species, Schistosoma japonicum is primarily associated with schistosomiasis in East Asia, particularly in countries like China, the Philippines, and Indonesia. The clinical presentation, signs, symptoms, and patient characteristics associated with ICD-10 code B65.2 (Schistosomiasis due to Schistosoma japonicum) are critical for diagnosis and management.

Clinical Presentation

Acute Phase

The acute phase of schistosomiasis due to Schistosoma japonicum often occurs within weeks of infection. Patients may experience:

• Katayama Syndrome: This is a hypersensitivity reaction characterized by fever, malaise, fatigue, and myalgia. It can also include gastrointestinal symptoms such as diarrhea and abdominal pain.
• Rash: A pruritic rash may develop at the site of cercarial penetration, often referred to as cercarial dermatitis.

Chronic Phase

If untreated, the disease can progress to a chronic phase, which may manifest as:

• Abdominal Symptoms: Chronic abdominal pain, diarrhea, and weight loss are common. Patients may also experience hepatosplenomegaly due to portal hypertension.
• Genitourinary Symptoms: In some cases, Schistosoma japonicum can affect the urinary tract, leading to hematuria (blood in urine) and dysuria (painful urination).
• Neurological Symptoms: Although less common, neurological manifestations can occur, including seizures and signs of increased intracranial pressure due to neuroschistosomiasis.

Signs and Symptoms

Common Symptoms

• Fever: Often low-grade but can be higher during the acute phase.
• Fatigue and Weakness: General malaise is prevalent, especially in the acute phase.
• Gastrointestinal Disturbances: Diarrhea, abdominal pain, and nausea are frequently reported.
• Weight Loss: Chronic infection can lead to significant weight loss due to malabsorption and decreased appetite.

Physical Examination Findings

• Hepatosplenomegaly: Enlarged liver and spleen are common findings in chronic cases.
• Abdominal Tenderness: May be noted during physical examination, particularly in the right upper quadrant.
• Rash: A rash may be observed at the site of cercarial entry.

Patient Characteristics

Demographics

• Geographic Distribution: Patients are often from endemic areas in East Asia, particularly rural regions where water contact is common.
• Age: Schistosomiasis can affect individuals of all ages, but children and young adults are often more affected due to increased exposure to contaminated water sources.

Risk Factors

• Occupational Exposure: Individuals working in agriculture, fishing, or other water-related occupations are at higher risk.
• Recreational Water Use: Swimming or bathing in freshwater bodies in endemic areas increases the risk of infection.
• Travel History: Recent travel to endemic regions can be a significant factor in the clinical presentation of schistosomiasis.

Conclusion

Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with ICD-10 code B65.2 is essential for healthcare providers in diagnosing and managing schistosomiasis due to Schistosoma japonicum. Early recognition and treatment are crucial to prevent complications associated with chronic infection, such as liver damage and portal hypertension. If you suspect schistosomiasis in a patient with relevant exposure history, consider further diagnostic testing and appropriate treatment options.

Schistosomiasis due to Schistosoma japonicum is classified under the ICD-10 code B65.2. This specific type of schistosomiasis is primarily associated with infections caused by the Schistosoma japonicum parasite, which is prevalent in parts of Asia, particularly in China, the Philippines, and Indonesia. Below are alternative names and related terms associated with this condition.

Alternative Names

1. Japanese Schistosomiasis: This term is often used due to the geographical association of Schistosoma japonicum with Japan and other East Asian countries.
2. Bilharziasis: A broader term that refers to schistosomiasis in general, which can be caused by various species of schistosomes, including Schistosoma japonicum.
3. Intestinal Schistosomiasis: This term may be used to describe the intestinal manifestations of the disease, which are common with S. japonicum infections.

Related Terms

1. Schistosomiasis: The general term for infections caused by schistosome parasites, which includes several species such as Schistosoma mansoni, Schistosoma haematobium, and Schistosoma japonicum.
2. Schistosomiasis japonica: Another scientific name that refers specifically to the disease caused by Schistosoma japonicum.
3. Acute Schistosomiasis: Refers to the early phase of the infection, which can present with various symptoms.
4. Chronic Schistosomiasis: This term describes the long-term effects and complications that can arise from untreated infections, including liver and intestinal damage.
5. Schistosomiasis-related Hepatic Fibrosis: A condition that can develop as a complication of chronic schistosomiasis, particularly with S. japonicum.

Conclusion

Understanding the alternative names and related terms for ICD-10 code B65.2 is essential for healthcare professionals, researchers, and public health officials. This knowledge aids in accurate diagnosis, treatment, and epidemiological studies related to schistosomiasis due to Schistosoma japonicum. If you need further information on treatment options or epidemiological data, feel free to ask!

The diagnosis of schistosomiasis due to Schistosoma japonicum (ICD-10 code B65.2) involves a combination of clinical evaluation, laboratory testing, and epidemiological factors. Below is a detailed overview of the criteria used for diagnosis.

Clinical Presentation

Symptoms

Patients with schistosomiasis may present with a variety of symptoms, which can range from mild to severe. Common clinical manifestations include:

• Acute Phase: Symptoms may include fever, chills, cough, and abdominal pain, often occurring after exposure to contaminated water.
• Chronic Phase: Long-term complications can involve gastrointestinal symptoms such as diarrhea, abdominal pain, and hepatosplenomegaly. In severe cases, it can lead to portal hypertension and associated complications[2][3].

History of Exposure

A critical aspect of diagnosis is the patient's history, particularly:

• Travel History: Recent travel to endemic areas, particularly in parts of Asia where S. japonicum is prevalent, is a significant indicator.
• Exposure to Freshwater: Activities such as swimming, fishing, or bathing in freshwater bodies in endemic regions increase the risk of infection[2][3].

Laboratory Testing

Serological Tests

Serological assays can be used to detect antibodies against S. japonicum. These tests are particularly useful in areas where the disease is endemic and can help confirm exposure.

Stool Examination

The definitive diagnosis of schistosomiasis is often made through the identification of eggs in stool samples. The following methods are commonly employed:

• Microscopic Examination: Stool samples are examined for the presence of S. japonicum eggs, which are oval and have a characteristic shape.
• Concentration Techniques: Techniques such as the Kato-Katz method can enhance the detection of eggs by concentrating them from larger stool volumes[2][3].

Imaging Studies

In some cases, imaging studies such as ultrasound or CT scans may be utilized to assess organ involvement, particularly the liver and spleen, which can show signs of schistosomiasis-related damage[2].

Epidemiological Criteria

Geographic Distribution

The presence of schistosomiasis is closely linked to geographic factors. S. japonicum is primarily found in:

• Parts of East Asia, including China, the Philippines, and Indonesia.
• Areas with freshwater bodies where the intermediate host (snails) is present[2][3].

Public Health Data

Epidemiological data, including reports of outbreaks or endemic cases in specific regions, can support the diagnosis. Health authorities often monitor these factors to identify and manage schistosomiasis cases effectively[2].

Conclusion

The diagnosis of schistosomiasis due to Schistosoma japonicum (ICD-10 code B65.2) relies on a comprehensive approach that includes clinical evaluation, laboratory testing, and consideration of epidemiological factors. Accurate diagnosis is crucial for effective treatment and management of the disease, particularly in endemic regions. If you suspect schistosomiasis, it is essential to consult healthcare professionals who can perform the necessary tests and provide appropriate care.

Schistosomiasis due to Schistosoma japonicum (ICD-10 code B65.2) is a parasitic disease that primarily affects the liver and intestines, and it is prevalent in parts of Asia, particularly in China, the Philippines, and Indonesia. The standard treatment approaches for this condition focus on antiparasitic medications, supportive care, and management of complications. Below is a detailed overview of the treatment strategies.

Antiparasitic Medications

1. Praziquantel

Praziquantel is the first-line treatment for schistosomiasis, including infections caused by Schistosoma japonicum. This medication works by causing severe spasms and paralysis of the worms, leading to their detachment from the blood vessels and subsequent elimination from the body. The typical dosage for adults is 40 mg/kg, administered in two or three doses over a day[3][4].

2. Alternative Treatments

While praziquantel is the most commonly used drug, in cases where patients may have contraindications or resistance, alternative treatments may be considered. However, these alternatives are less commonly used and may not be as effective. Research into other antiparasitic agents is ongoing, but praziquantel remains the gold standard[3].

Supportive Care

1. Symptomatic Management

Patients with schistosomiasis may experience a range of symptoms, including abdominal pain, diarrhea, and fatigue. Supportive care involves managing these symptoms through hydration, nutritional support, and pain relief as needed. In cases of severe anemia or malnutrition, additional interventions may be required[4].

2. Monitoring and Follow-Up

Regular follow-up is essential to monitor the effectiveness of treatment and to check for any potential complications, such as liver damage or portal hypertension. This may involve periodic stool examinations to confirm the clearance of the parasite and assess the patient's overall health status[3].

Management of Complications

1. Liver and Gastrointestinal Complications

In cases where schistosomiasis has led to significant liver damage or portal hypertension, more specialized interventions may be necessary. This can include endoscopic procedures for variceal bleeding or surgical interventions for severe complications[4].

2. Neuroschistosomiasis

Although less common, if the infection leads to neuroschistosomiasis, additional treatments may be required, including corticosteroids to reduce inflammation and further neurological evaluation and management[3].

Conclusion

The standard treatment for schistosomiasis due to Schistosoma japonicum primarily involves the use of praziquantel, supported by symptomatic care and monitoring for complications. Early diagnosis and treatment are crucial to prevent long-term health issues associated with this parasitic infection. Regular follow-up and management of any arising complications are essential components of comprehensive care for affected individuals.