Katayama Fever
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During a 3-month elective in Uganda, a 24-year-old Dutch medical student swam in the Nile River. Two months after his return, he presented to a clinic with a 7-week history of a nonproductive cough and malaise, as well as a 2-week history of diarrhea and nonpruritic rash. Physical examination and diagnostic testing revealed multiple small papules on the trunk (Panel A), eosinophilia,mildly elevated liver-function values, and several ill-defined nodular infiltrates on the chest radiograph (Panel B, arrows). Tests were positive for antibodies against schistosomal worms but not for antibodies against schistosomal eggs. Analysis of a skin-lesion biopsy specimen revealed nonspecific eosinophilic infiltrates without eggs. These findings support the diagnosis of acute schistosomiasis, or Katayama fever.Treatment with a single oral dose of praziquantel, preferably given after the acute stage, typically results in complete cure, as was seen in this patient...

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