Schistosomiasis Mansoni Manifesting as Multiple Colonic Polyps

Abstract

Schistosomiasis (bilharziasis) is a common parasitic disease in subtropical and tropical parts of Africa, some parts of the Middle East, South America, Asia, and some parts of the Caribbean. It is a major public health problem and associated with significant morbidity and mortality in endemic areas. We describe a 28-year-old male patient presenting with bleeding per rectum associated with mucus secretion, abdominal pain, anorexia, and weight loss. Blood investigation showed pancytopenia with macrocytic hypochromic anemia. Meanwhile, his colonoscopy showed two large polyps 10 cm and 50 cm away from the anal verge, each measuring 3 cm in size. Microscopic examination of multiple colonic biopsies confirmed Schistosoma mansoni. The patient was treated with praziquantel, which improved his condition. Colonic schistosomiasis is an important differential diagnosis in patients with a history of travel to endemic areas. Early diagnosis and medical management can avoid unnecessary invasive intervention in such cases.