Rare presentation of gallbladder schistosomiasis: a case report

Area of Science:

• Parasitology
• Tropical Medicine
• Gastroenterology

Background:

• Schistosomiasis is a significant parasitic disease, second only to malaria in prevalence.
• Intestinal and urogenital schistosomiasis are common, but gallbladder involvement is exceptionally rare.
• Gallbladder schistosomiasis typically presents with imaging findings mimicking acute cholecystitis.

Observation:

• A middle-aged male presented with abdominal distention and iron deficiency anemia.
• Initial imaging revealed a distended gallbladder with septations and a gallstone, but lacked typical signs of cholecystitis.
• Further MRI showed gallbladder stones with multiseptated mural lesions, but no wall thickening or pericholecystic fluid.

Findings:

• Histopathological examination post-cholecystectomy confirmed chronic granulomatous inflammation in the gallbladder wall.
• Schistosoma-like ova were identified in the mucosa and submucosa, consistent with schistosomiasis.
• Periodic acid-Schiff staining confirmed the presence of ova.

Implications:

• This case underscores that gallbladder schistosomiasis can present atypically, without classic imaging features of cholecystitis.
• It highlights the importance of considering parasitic infections in the differential diagnosis of gallbladder disease, especially in endemic areas.
• Accurate diagnosis through histopathology is crucial for appropriate management of rare parasitic gallbladder involvement.