It may be difficult to diagnose schistosomiasis in an immunocompromised patient by standard methods. A high index of suspicion and identification of risk factors are important for making the diagnosis.
Reasons schistosomiasis may be difficult to diagnose in an immunocompromised patient:
(1) The number of eggs produced and released are reduced.
(2) The number of eggs detectable by mucosal biopsy are reduced.
(3) The titer of anti-schistosomal antibodies may be low.
Ways to make the diagnosis:
(1) PCR can be helpful if it is available.
(2) Repeated studies to detect eggs.
(3) Consider a therapeutic trial.
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