OBJECTIVES: To investigate the characteristics of imported Katayama fever (acute 
schistosomiasis) as well as evolution and outcome under treatment.
METHODS: Between April 2000 and September 2004, we included prospectively all 
patients with confirmed diagnosis of Katayama fever. Follow-up was maintained at 
least until 6 months after symptoms resolved. Praziquantel (PZQ) was given as 
soon as the diagnosis was probable, most of the time with steroids.
RESULTS: Twenty-three patients were diagnosed with Katayama fever by Schistosoma 
egg detection and/or by seroconversion. Clinical features were non-specific, 
with mainly respiratory and/or gastrointestinal symptoms. Diagnosis was 
confirmed at presentation in 17/23 (74%) patients, of whom 15 by serology. 
Immediate clinical exacerbation occurred in five of nine patients not given 
steroids concomitantly with PZQ. After initial resolution, fever recurred in 
five (22%) patients. When compiling initial and recurrent episodes (n=28), 
respiratory symptoms tended to occur at an earlier stage after exposure, while 
abdominal complaints were more frequent later. All patients were completely 
cured, sometimes after repeated treatments.
CONCLUSIONS: Clinical presentation of Katayama fever is non-specific and 
involves respiratory and abdominal symptoms. Recurrence of fever is not unusual 
despite anti-helminthic treatment. Optimal therapeutic strategy remains to be 
defined to prevent recurrence.