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[Surprising findings in the colon 15 years after a holiday in Africa]
S Köppen1, U Kellner, H Huchzermeyer
1Medizinische Klinik, Klinikum Minden. s.koeppen@gmx.de
History And Admission Findings:
A 65-year-old woman was admitted to hospital with abdominal discomfort for several years. Travel history revealed two 4-week stays in Mwanza/Tanzania 15 and 17 years earlier.
Investigations:
Laboratory tests showed eosinophilia and an increase of IgE and antibodies against Schistosoma mansoni (IHA, EIA). Stool was negative for worm eggs. Colonoscopy revealed in several parts small nodules and increased vascularisation. Histology showed granulomas and eggs of Schistosoma mansoni.
Treatment And Course:
Anthelmintic therapy with praziquantel was given. After that the patient was well. One year later, follow-up endoscopy and histology were the same as previously. Another course of Praziquantel was given. A year later the patient was still well.
Conclusion:
Even after several years the rare case of intestinal schistosomiasis should be considered in patients with a history of travel in endemic regions. In case of negative stool specimen biopsies of the colon and rectum should be taken.
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