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Published on: September 22, 2019
A Diagnostic Pitfall: Chronic Schistosomiasis Presenting With Inflammatory Bowel Disease-Like Symptoms in an Endemic
Afraa Mohammed1, Hala Abdalla1, Alaa Mohamed2
1Gastroenterology and Hepatology, Sudan National Center for Gastrointestinal and Liver Diseases, Khartoum, SDN.
Abstract:
A 24-year-old male presented with a two-year history of intermittent bloody diarrhoea and central abdominal pain that had gradually worsened, accompanied by joint discomfort and backache. He denied direct exposure to irrigation canals, drains, or freshwater bodies usually linked to schistosomiasis transmission. However, he recalled occasional visits to the Nile Corniche where his feet had contact with fresh water. Laboratory investigations revealed marked eosinophilia (14%), which, in combination with intestinal and extra-intestinal features, raised suspicion for inflammatory bowel disease. Colonoscopy showed diffuse reddish patches with mild exudation but lacked a conclusive diagnosis. Histopathological analysis confirmed chronic schistosomiasis through the identification of viable Schistosoma ova, sessile polyps, and eosinophilic granulomas. The patient received 2400 mg of praziquantel and experienced complete resolution of symptoms.
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