oa South African Medical Journal - The Katayama syndrome



Twelve cases of the Katayama syndrome or toxaemic stage of bilharzia are descriptionbed. The clinical picture of fever, headache, cough, abdominal pain, urticaria, enlarged liver, enlarged spleen and a high blood eosinophilia is descriptionbed in detail. The syndrome in this country is caused by S. haematobium or S. mansoni. Mixed infections also occur. Of 10 cases in which ova were found 7 had S. mansoni in the stools and it is suggested that this infection is becoming more prevalent in this area. The eosinophilia is usually very high and may reach 80%. The bilharzial complement-fixation test may be a useful diagnostic test. In areas where bilharzia is endemic the Katayama syndrome should be considered when an unexplained fever presents. The impression has been gained that treatment with large doses of 'nilodin' (100 mg. per Ib body weight over 8 days) is at least as satisfactory as intramuscular antimony in cases due to S. haematobium. In those due to S. mansoni it is thought best to follow 'nilodin' with antimony and to repeat the course later.


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