ACUTE AND CHRONIC SCHISTOSOMIASIS

For most American physicians, the mention of schistosomiasis evokes vague memories of ''that parasite lecture we had in medical school.'' Few clinical facts are recalled. This situation is unfortunate, since estimates made by the World Health Organization indicate that more than 300 million people around the world live in an environment in which they are regularly exposed to schistosome infection. Thus, recent changes in immigration patterns, along with recent increases in recreational travel to ''exotic'' locations, have made it much more likely that a physician in the United States will be confronted by a case. A working understanding of the life cycle of schistosome infection and an understanding of the immunologic basis of infection-associated disease will allow rapid assessment of the risk of schistosomiasis in a given patient. The case presentations that follow illustrate the role of clinical information in establishing the diagnosis of schistosomiasis in two quite different settings.