skip to main content

Early schistosomiasis treatment — DTM&H MCQ

Instant feedback + full explanation. One question, done properly.

ModerateHelminthic InfectionsEarly schistosomiasis treatmentDTM&H

A 36-year-old traveller returns from Malawi with fever and eosinophilia 6 weeks after swimming in Lake Malawi. Stool and urine microscopy are negative. Schistosome serology is positive. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Treat with praziquantel 40 mg/kg and repeat after 6 weeks

In early schistosomiasis (Katayama syndrome), egg excretion may not have started as worms need 5-12 weeks to mature. Positive serology with compatible exposure history warrants treatment with praziquantel. A second dose at 6 weeks ensures any immature worms that were not killed by the first dose are treated once mature. Waiting for positive microscopy delays treatment and allows ongoing immune-mediated damage.

Reference: UKHSA Schistosomiasis Guidelines; Manson's Tropical Diseases