Schistosomal colitis without granuloma formation in a kidney transplant recipient

A 40-year-old male from the White Nile region in Sudan, who had received a kidney transplant 6 years previously, presented with fever, lower abdominal pain and diarrhea stained with blood of 5 months duration. He was on immunosuppressive maintenance therapy, consisting of ciclosporin 75 mg twice daily, prednisolone 10 mg once daily, and azathioprine 75 mg once daily.

Laboratory investigations, liver function tests, renal function tests, stool microscopy, stool culture, abdominal ultrasound, and colonoscopy.

Severe, left-sided colitis due to Schistosoma mansoni infection, without granuloma formation.

Oral antischistosomal therapy with praziquantel at a dose of 40 mg/kg body weight.