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Katayama fever

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These are broadly similar for all species and include:

  • circarial dermatitis / "swimmer's itch" - this occurs when the parasites initially enter the skin

  • "Katayama fever" - subsequent general malaise, low-grade fever, and eosinophilia - as a result of haematogenous spread
    • this is an allergic response and usually develops 1-2 months after contact with contaminated water. May be associated with abdominal pain, hepatomegaly, splenomegaly, and diarrhoea. Generally, self-limiting. Katayama fever is more noticeable in S. japonicum infection than other forms
    • serological testing and stool and urine testing will be negative in this phase of the illness (1). Worms take six to ten weeks to start egg production and so screening tests for schistosomiasis should be delayed until about 12 weeks after last exposure (1).

  • further clinical features depend whether the infection leads to urinary schistomiasis (S. haemotobium) or intestinal schistosomiasis (S. mansoni, S. japonicum, S. intercalatum, S. mekongki)

Note that the majority of travellers with acute infection will be asymptomatic, the most commonly reported symptom being tiredness (1).


  1. Pulse (2004); 64 (31); 44.