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The Diagnosis of Schistosomiasis Japonica

II. THE DIAGNOSTIC CHARACTERISTICS OF THE EGGS OF THE ETIOLOGIC AGENT SCHISTOSOMA JAPONICUM

1. This presentation acquaints the clinical microscopist with the relatively complex problem involved in the diagnosis of schistosomiasis japonica in so far as recognition of the eggs of the parasite are concerned.

2. Typical mature viable eggs of Schistosoma japonicum are not always found in the stools of patients infected with this blood fluke. In their place there may be immature eggs, either viable or degenerate, degenerate mature eggs or eggs in a pseudo-abscess or pseudo-tubercle capsule which has been enucleated from its location in the intestinal wall.

3. The process of egg laying in the mesenteric venules is described, together with the escape of the eggs from the venules, their filtration through the submucous and mucous coats of the intestinal wall and their appearance in flecks and strands of mucus and in the feces of the evacuated stool.

4. Detailed descriptions are provided of the immature and mature viable eggs, immature and mature degenerate eggs, nests of eggs trapped in mucus, eggs recovered from intestinal nodules and from dilated intestinal capillaries, egg-shells, and the type of spine or protuberance which at times characterizes the shell of the egg of S. japonicum. These stages and types are illustrated by camera lucida drawings and by a photomicrograph.

5. The diagnostic and prognostic significance of the relative number and types of S. japonicum eggs recovered from the stools of patients undergoing treatment is indicated by a representative case in which careful quantitative and qualitative study of the eggs was made before, during and immediately following a 75 cc. course of treatment with fuadin.

¹ Department of Tropical Medicine, Tulane University of Louisiana, New Orleans, La. Director, Commission on Schistosomiasis, Commission on Tropical Diseases, Army Epidemiological Board, Preventive Medicine Service, Office of the Surgeon General, Washington, D. C.