Imported Katayama fever: clinical and biological features at presentation and during treatment.
OBJECTIVE
To investigate the characteristics of imported Katayama fever (acute schistosomiasis) as well as evolution and outcome under treatment.


METHODS
Between April 2000 and September 2004, we included prospectively all patients with confirmed diagnosis of Katayama fever. Follow-up was maintained at least until 6 months after symptoms resolved. Praziquantel (PZQ) was given as soon as the diagnosis was probable, most of the time with steroids.


RESULTS
Twenty-three patients were diagnosed with Katayama fever by Schistosoma egg detection and/or by seroconversion. Clinical features were non-specific, with mainly respiratory and/or gastrointestinal symptoms. Diagnosis was confirmed at presentation in 17/23 (74%) patients, of whom 15 by serology. Immediate clinical exacerbation occurred in five of nine patients not given steroids concomitantly with PZQ. After initial resolution, fever recurred in five (22%) patients. When compiling initial and recurrent episodes (n=28), respiratory symptoms tended to occur at an earlier stage after exposure, while abdominal complaints were more frequent later. All patients were completely cured, sometimes after repeated treatments.


CONCLUSIONS
Clinical presentation of Katayama fever is non-specific and involves respiratory and abdominal symptoms. Recurrence of fever is not unusual despite anti-helminthic treatment. Optimal therapeutic strategy remains to be defined to prevent recurrence.
Bottieau
Emmanuel
E
Department of Clinical Sciences, Institute of Tropical Medicine (IMTA), Nationalestraat 155, 2000 Antwerp, Belgium. ebottieau@itg.be
Clerinx
Jan
J
de Vega
Maria Rosario
MR
Van den Enden
Erwin
E
Colebunders
Robert
R
Van Esbroeck
Marjan
M
Vervoort
Tony
T
Van Gompel
Alfons
A
Van den Ende
Jef
J
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D017954:Africa South of the Sahara; D000871:Anthelmintics / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D005060:Europe; D005260:Female; D005334:Fever; D006801:Humans; D008297:Male; D008875:Middle Aged; D011223:Praziquantel / Q000627:therapeutic use; D012008:Recurrence; D012552:Schistosomiasis / Q000175:diagnosis* / Q000188:drug therapy*; D014195:Travel
D000305:Adrenal Cortex Hormones; D000871:Anthelmintics; D000893:Anti-Inflammatory Agents; D011223:Praziquantel