Rarely a patient with schistomiasis may develop endomyocardial fibrosis (EMF) with or without pulmonary hypertension. This may be a case of Loeffler’s endocarditis or a mere coincidence.
Most cases have reported S. mansoni as the species involved.
Clinical features:
(1) The patient has schistosomiasis.
(2) The patient has persistent hypereosinophilia.
(3) The patient develops endomyocardial fibrosis affecting the left ventricle, the right ventricle, or both ventricles.
Pulmonary hypertension and peripheral emboli can occur with prolonged left ventricular EMF.
Ascites and pericardial effusion can occur with right ventricular EMF.
Differential diagnosis:
(1) schistosomal cardiomyopathy (associated with myocardial granulomas)
(2) endomyocardial fibrosis due to other cause
(3) Loeffler’s endocarditis due to other cause (microfilariasis, other parasitic infection)
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