Dr Mattias Larsson*

During the Christmas break, Ethan, a curious and lively 12-year-old boy, travelled from Việt Nam to Cambodia with his parents. They visited Angkor Wat and did other adventures such as zip-lining and canoeing along the serene waterways of the Mekong River surrounded by lush greenery. 

Shortly after their return from Cambodia to Việt Nam, Ethan began experiencing unusual symptoms. Initially, he complained of fatigue, headaches and mild abdominal pain. His parents attributed these to being tired from travelling or perhaps a mild stomach bug picked up during their trip. However, within weeks, the symptoms escalated. Ethan developed a persistent fever, severe abdominal cramps, diarrhoea and an itchy rash. 

Worried about their son’s condition, the parents sought help from a local clinic that diagnosed food poisoning and bacterial infection and prescribed antibiotics. However, Ethan’s condition worsened. They visited another clinic that also diagnosed a bacterial infection and prescribed another antibiotic, combined with steroids and antihistamines. The treatment decreased the symptoms for a while but then they came back worse. Ethan’s parents grew increasingly desperate.  

Schistosomiasis, also called bilharzia, is an infection caused by tiny parasitic worms that lives in freshwater and can enter the body through the skin. — Photo canva.com

After weeks of ineffective treatments, the family decided to visit Family Medical Practice (FMP), as they had heard it had international standards and good diagnostic capacity for complex medical conditions. The paediatrician listened carefully to Ethan’s travel history and symptoms and suspected it might be a parasitic disease. The doctor asked: “Have you been swimming or wading in freshwater recently?” Ethan’s parents mentioned the canoeing trip in Cambodia and that Ethan waded into the water. 

The paediatrician ordered blood tests and a stool sample analysis, including schistosomiasis, a parasitic infection caused by freshwater worms called schistosomes. Within a day, the results confirmed the diagnosis. Ethan had contracted schistosomiasis, likely during his canoeing adventure in Cambodia. 

The paediatrician explained that schistosomiasis, also called bilharzia, is an infection caused by tiny parasitic worms that live in freshwater and can enter the body through the skin. The parasite travels through the bloodstream and infects different organs, causing inflammation and damage. It’s common in parts of Southeast Asia, especially in rural areas where water may be contaminated. The infection could cause severe symptoms if untreated, but as it was diagnosed early it was still curable with the right medication. 

Ethan was prescribed praziquantel, an antiparasitic drug specifically used to treat schistosomiasis. The medication works by paralysing the worms, allowing the body to eliminate them naturally. The doctor explained to Ethan that he might feel slightly worse for a day or two as his body reacted to the dying parasites, but this was a positive sign that the treatment was working. 

As they started the treatment, Ethan began to improve within a week. His fever subsided, his appetite returned and his energy levels surged. Follow-up tests confirmed that the infection was eradicated, to his parents’ relief. 

The paediatrician advised the family on preventive measures for future travels. “Avoid contact with freshwater in regions where schistosomiasis is common. Stick to bottled or treated water and always consult a doctor if you notice unusual symptoms after a trip.” 

The parents felt relieved that FMP provided timely and accurate medical care. Ethan’s ordeal underscored the importance of considering all possibilities, especially parasitic infections, in regions where such conditions are prevalent. 

While Ethan’s adventure in Cambodia had an unexpected twist, it also taught the family valuable lessons about health, travel and the importance of seeking specialised care when needed. With his health restored, Ethan is now back to planning his next adventure – this time, with extra precautions in place. Family Medical Practice  

Dr Mattias Larsson. — Photo courtesy of Family Medical Practice

*Dr Mattias Larsson is a paediatric doctor at FMP Hanoi and associate professor at Karolinska Institutet and has extensive experience in research on infectious diseases. He has worked with the Oxford University Clinical Research Unit and the Ministry of Health of Việt Nam. He is fluent in English, Swedish, Vietnamese, German and some Spanish.

FMP Healthcare Group operates medical centres in major cities including HCM City, Hà Nội and Đà Nẵng, offering consultations with international doctors, check-up centres and emergency ambulance services.

Visit FMP Hanoi 24/7 at 298I Kim Mã Street, Kim Mã Ward, Ba Đình District. To book an appointment, please call (024).3843.0748, chat via Whatsapp, Viber or Zalo on +84.944.43.1919 or email hanoi@vietnammedicalpractice.com.