# Schistosomiasis - Category: infectious - Review status: reviewed (every claim checked against a document named on this page) - Sources: Egyptian MOH Schistosomiasis Protocol 2020 for the national regimen, with the dose from Egyptian National Drug Formulary - Antimicrobial 2023, praziquantel monograph (endf-antimicrobial-2023.txt): "S. haematobium, Schistosoma intercalatum, or S. mansoni: Oral: 40 mg/kg/day as a single dose or in 2 divided doses for 1 day" and "S. japonicum or S. mekongi: Oral: 60 mg/kg/day in 2 -3 divided doses for 1 day". The formulary states no absolute milligram ceiling; the 3600 mg cap here is 60 mg/kg at 60 kg. · Egyptian MOH Schistosomiasis Protocol 2020 · CDC Yellow Book 2024 · WHO Schistosomiasis 2022 - Verified date: 2026-08 ## Verified against - Egyptian MOH Schistosomiasis Protocol 2020 for the national regimen, with the dose from Egyptian National Drug Formulary - Antimicrobial 2023, praziquantel monograph (endf-antimicrobial-2023.txt): "S. haematobium, Schistosoma intercalatum, or S. mansoni: Oral: 40 mg/kg/day as a single dose or in 2 divided doses for 1 day" and "S. japonicum or S. mekongi: Oral: 60 mg/kg/day in 2 -3 divided doses for 1 day". The formulary states no absolute milligram ceiling; the 3600 mg cap here is 60 mg/kg at 60 kg. - Egyptian MOH Schistosomiasis Protocol 2020 ## Treatment metadata - Praziquantel — 600 mg — oral.solid ## Complete treatment card ```text SCHISTOSOMIASIS Sources: Egyptian MOH Schistosomiasis Protocol 2020 for the national regimen, with the dose from Egyptian National Drug Formulary - Antimicrobial 2023, praziquantel monograph (endf- antimicrobial-2023.txt): "S. haematobium, Schistosoma intercalatum, or S. mansoni: Oral: 40 mg/kg/day as a single dose or in 2 divided doses for 1 day" and "S. japonicum or S. mekongi: Oral: 60 mg/kg/day in 2 -3 divided doses for 1 day". The formulary states no absolute milligram ceiling; the 3600 mg cap here is 60 mg/kg at 60 kg. · Egyptian MOH Schistosomiasis Protocol 2020 · CDC Yellow Book 2024 · WHO Schistosomiasis 2022 Review status: REVIEWED against 2 sources listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (9) - Most people have no symptoms or only very mild, subtle complaints - An itchy, spotty rash can appear 2 to 7 days after larvae get through the skin during freshwater contact [itching · rash] - A feverish illness called Katayama fever can follow 3 to 8 weeks after the skin rash or water exposure [fever · rash] - Katayama fever often brings nonspecific fever, fatigue, and gut or chest symptoms, resolving on its own within 2 to 10 weeks [fatigue · fever] - Roughly 2 percent develop neurological features such as headache, seizures, or acute encephalopathy [headache · seizures] - Chronic bowel or liver disease can bring long-standing abdominal pain, intermittent diarrhoea, GI bleeding with anaemia, and progressive tiredness [abdominal pain · anaemia · bleeding · diarrhoea · fatigue] - Advanced portal hypertension can cause abdominal swelling, early fullness, or bleeding suggestive of varices [abdominal distension · bleeding · hypertension] - Gross terminal haematuria is the classic presenting complaint of urinary schistosomiasis [blood in the urine] - Men may also notice blood in the semen; both sexes may report dysuria, frequency, suprapubic discomfort, or pain with intercourse [abdominal pain · burning on passing urine · lower abdominal pain] SIGNS - what you find (3) - Bleeding from the genital mucosa, unusual small blood vessels, and gritty sand-like patches over the vulva, perineum, or cervix are described [bleeding] - Speculum exam may reveal sandy patches, increased vascularity, and friability of the cervix or vaginal wall - An elevated absolute eosinophil count can be the only clue in otherwise silent chronic infection TESTS (11) - Kato-Katz stool microscopy is the reference test for S. mansoni, though sensitivity is limited - Stool testing covers S. mansoni, and also S. japonicum, S. mekongi, plus S. intercalatum; urine is the specimen for S. haematobium - Collecting three stool samples on separate days improves the diagnostic yield - Eggs seen on microscopy are large and oval, measuring 110 to 170 by 40 to 70 micrometres - A prominent terminal spine marks S. haematobium eggs, while a lateral spine marks S. mansoni eggs - Serology cannot tell active infection from past exposure in people living in endemic areas - Serology for acute disease is best drawn 6 to 8 weeks or more after exposure, giving antibodies time to appear - A point-of-care urine antigen test for circulating cathodic antigen is a specific, sensitive marker of active infection - Antigen levels fall over days to weeks after praziquantel treatment, useful for tracking response - Pelvic ultrasound can show bladder wall thickening or irregularity, hydronephrosis, polyps, or masses - Plain films can show bladder wall calcification in advanced disease, further characterised on CT IF NOT THIS - what else fits (6) - In acute disease, EBV, CMV, acute HIV, malaria, and enteric fever mimic Katayama fever - Strongyloidiasis, toxocariasis, rickettsial infection, and dengue or other arboviruses are also considered - Drug hypersensitivity should be considered, particularly when eosinophilia is present - Chronic hepatosplenic disease needs distinguishing from viral hepatitis, other causes of cirrhosis, noncirrhotic portal hypertension, and infiltrative liver disease - Urogenital disease overlaps with urinary infection, kidney stones, genitourinary TB, and a sexually transmitted infection - Other causes of infertility and bladder cancer are also on the urogenital differential Source StatPearls "Schistosomiasis" - disease-level clinical article Status traced to the source above 1. PRAZIQUANTEL [1st line] Adult 40 mg/kg single dose (or 60 mg/kg divided in 2 doses 4h apart) - single-dose Peds 40-60 mg/kg/day [child max 3600 mg] (Single dose or divided into 2 doses 4 hours apart; take after a meal) 3kg -> 120-180 mg/day 4kg -> 160-240 mg/day 5kg -> 200-300 mg/day 6kg -> 240-360 mg/day 7kg -> 280-420 mg/day 8kg -> 320-480 mg/day 9kg -> 360-540 mg/day 10kg -> 400-600 mg/day 11kg -> 440-660 mg/day 12kg -> 480-720 mg/day 13kg -> 520-780 mg/day 14kg -> 560-840 mg/day 15kg -> 600-900 mg/day 16kg -> 640-960 mg/day 17kg -> 680-1020 mg/day 18kg -> 720-1080 mg/day 19kg -> 760-1140 mg/day 20kg -> 800-1200 mg/day 21kg -> 840-1260 mg/day 22kg -> 880-1320 mg/day 23kg -> 920-1380 mg/day 24kg -> 960-1440 mg/day 25kg -> 1000-1500 mg/day 26kg -> 1040-1560 mg/day 27kg -> 1080-1620 mg/day 28kg -> 1120-1680 mg/day 29kg -> 1160-1740 mg/day 30kg -> 1200-1800 mg/day 31kg -> 1240-1860 mg/day 32kg -> 1280-1920 mg/day 33kg -> 1320-1980 mg/day 34kg -> 1360-2040 mg/day 35kg -> 1400-2100 mg/day 36kg -> 1440-2160 mg/day 37kg -> 1480-2220 mg/day 38kg -> 1520-2280 mg/day 39kg -> 1560-2340 mg/day 40kg -> 1600-2400 mg/day 41kg -> 1640-2460 mg/day 42kg -> 1680-2520 mg/day 43kg -> 1720-2580 mg/day 44kg -> 1760-2640 mg/day 45kg -> 1800-2700 mg/day 46kg -> 1840-2760 mg/day 47kg -> 1880-2820 mg/day 48kg -> 1920-2880 mg/day 49kg -> 1960-2940 mg/day 50kg -> 2000-3000 mg/day Source Egyptian MOH Schistosomiasis Protocol 2020 for the national regimen, with the dose from Egyptian National Drug Formulary - Antimicrobial 2023, praziquantel monograph (endf- antimicrobial-2023.txt): "S. haematobium, Schistosoma intercalatum, or S. mansoni: Oral: 40 mg/kg/day as a single dose or in 2 divided doses for 1 day" and "S. japonicum or S. mekongi: Oral: 60 mg/kg/day in 2 -3 divided doses for 1 day". The formulary states no absolute milligram ceiling; the 3600 mg cap here is 60 mg/kg at 60 kg. Why Praziquantel is the sole listed treatment because it is the only drug in routine use; oxamniquine was withdrawn globally. Caution Egyptian MOH: 40 mg/kg for S. haematobium, 60 mg/kg for S. mansoni Abdominal pain may occur due to dead worm expulsion. This is a bitter tablet - take it with liquid during a meal without chewing. Dizziness and headache are common; do not drive for 24 hours. Egypt PRAZIQUANTEL 600MG 4 F.C. TAB. UP PHARMA 6.25 EGP (1.56/unit) PRAZIQUANTEL 600MG 4 F.C.TAB. SEDICO 6.50 EGP (1.62/unit) EPIQUANTEL 600MG 4 F.C. TABS. EIPICO 32.00 EGP (8.00/unit) BILTRICIDE 600 MG 4 F.C.TABS. ALEXANDRIA 33.00 EGP (8.25/unit) SCHISTOCIDE 600MG/5ML SUSP. 15ML DELTA PHARMA 7.00 EGP -> ? strength differs, ? different route - not oral solid Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)