Schistosomiasis: Patient Diagnosis II - Dr. William Howlett

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Tropical Parasitology: Protozoans, Worms, Vectors and Human Diseases

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Duke University

Tropical Parasitology: Protozoans, Worms, Vectors and Human Diseases

180 notes

This course provides students an understanding of important human parasitic diseases, including their life cycles, vectors of transmission, distribution and epidemiology, pathophysiology and clinical manifestations, treatment, and prevention and control. Tropical Parasitology is taught by faculty from an area highly impacted by tropical parasites- the Kilimanjaro Christian Medical University College in Moshi, Tanzania. The faculty include Drs. Frank Mosha and Mramba Nyindo (and two lecturers, Drs. Johnson Matowo and Jovin Kitau). Dr. John Bartlett, Professor of Medicine, Global Health and Nursing at Duke University, joins his faculty colleagues in this effort.

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Trematodes

The Trematodes cluster focuses on schistosomiasis and fascioliasis. It is estimated that almost 60 million people are infested with trematodes globally. This cluster has a total of 79 minutes of video and 31 pages of reading spread out over the two lessons. You will have unlimited opportunities to take an untimed quiz after you’ve mastered the material in each lesson, and you have two quizzes to complete for this cluster. This cluster begins by looking at schistosomiasis, a common intravascular infection caused by parasitic trematode worms in contaminated water.

Schistosomiasis: Epidemiology - Dr. Mramba Nyindo 12:03

Schistosomiasis: Vector - Dr. Mramba Nyindo 5:37

Schistosomiasis: Biology and Ecology - Dr. Mramba Nyindo15:03

Schistosomiasis: Pathophysiology - Dr. John Bartlett9:11

Schistosomiasis: Interview with Dr. Venance Maro 4:00

Schistosomiasis: Interview with Dr. William Howlett 11:19

Schistosomiasis: Patient Diagnosis I - Dr. William Howlett 6:47

Schistosomiasis: Patient Diagnosis II - Dr. William Howlett 3:05

Rencontrer les enseignants

John A. Bartlett, M.D.
Professor of Medicine, Global Health and Nursing at Duke University Medical Center
Duke Global Health Institute
Franklin Mosha, Ph.D.
Professor of Parasitology and Medical Entomology
Mramba Nyindo, Ph.D.
Associate Professor, Kilimanjaro Christian Medical University College (KCMU Co.)

So, this is our second patient today, and he's called Emmanuel He's a Masai man, and

he was admitted to us on the second of the fourth with, a history of, anemia.

And, the referral actually said his hemoglobin was down to 4.5 grams.

Now, this is typically what we see here.

When you examine his abdomen, the first thing that strikes you is a large mass in

his left side of his abdomen.

And in the area which we know corresponds to the spleen.

And when you look at him, [FOREIGN].

And you look for signs of anemia like we did with the last patient,

here you see the, the, the, the pallor, but

it's not as striking as the last patient, and his conjunctiva are pale, [FOREIGN].

And his tongue is,

is has some racial hyperpigmentation, which makes it difficult to interpret.

Just lie flat for a minute.

[FOREIGN] Uh-huh.

And then we come to his abdomen, and

what you see here is a large mass in the left side of his abdomen.

And clinically, this looks to us like a spleen.

So, when I go to examine that, I just put a hand gently in the right lower quadrant,

and then move in anticlockwise direction.

And here I can feel the edge of the mass.

And as I move up it, it's an edge and I can feel a notch.

And then, and there's the liver, I do feel liver edge.

And [FOREIGN] you see it moving down.

Moving down.

And, and that confirms that it's in his spleen.

It's superficial.

It's got a leading edge, a notch, and

if I do percussion, dullness that extends across there.

Down here we have the same looking for the liver and there's dullness there.

We can feel the liver edge.

I'm just presenting you that [FOREIGN] is another patient that

comes into us with a large liver.

Sorry, a large spleen.

And also possibly some slight liver enlargement.

>> Mm-hm. >> And

he doesn't seem to have free fluid like the last patient.

So in contrast to the last patient he's presenting with isolated organomegaly.

And the cause of his large liver and

spleen could in some ways overlap with schistosomiasis.

There are some features here which might suggest that it's not schistosomiasis.

He's under investigation for schistosomiasis.

Now, the way we screen for schistosomiasis is by history,

clinical examination and then by investigations.

And I'll talk about those in a minute.

To our knowledge [FOREIGN] is a traditional Masai man who has never been

exposed to schistosomiasis according to his history.

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