Alajab Mohamed B, Rafei Ahmed, Abdo Abdelmoneim E
Consultant Physician and Gastroenterologist, University of Gezira, Wadmadani.
Department of Research, The National Center for Gastrointestinal and Liver Diseases, Khartoum.
Ann Med Surg (Lond). 2024 Jun 21;86(8):4895-4897. doi: 10.1097/MS9.0000000000002300. eCollection 2024 Aug.
Schistosomiasis, caused by parasitic Schistosoma species, is a common neglected tropical disease prevalent in sub-Saharan Africa, including Sudan. While urinary tract infections are more frequent, intestinal schistosomiasis is rare. The disease presents with nonspecific symptoms, often leading to misdiagnosis as inflammatory bowel disease (IBD).
A 23-year-old male farmer from Gezira, Sudan, presenting with intermittent bloody diarrhea and mild left lower abdominal pain for 6 months. Despite multiple diagnoses and treatments for dysentery and IBD, his symptoms persisted. Colonoscopy revealed edematous mucosa with scattered whitish spots in the rectum, sigmoid, descending, and transverse colon, with normal findings in the ascending colon and cecum. Biopsies confirmed eosinophilic colitis with schistosomal egg shells. The patient was treated with praziquantel, leading to the resolution of symptoms within 2 weeks.
Schistosomiasis, caused by Schistosoma mansoni, commonly manifests with myalgia, fever, and rash, alongside abdominal symptoms. Diarrhea, abdominal pain, constipation, and weight loss are common. Stool examination and serological tests aid in diagnosis, but colonoscopy can reveal characteristic findings, such as edematous mucosa and schistosomal nodules. Early diagnosis and treatment with praziquantel are essential to prevent complications and improve patient outcomes.
This case emphasizes the importance of considering schistosomiasis in endemic areas when evaluating patients with colitis symptoms. Healthcare providers should maintain a high index of suspicion for this condition, especially in patients with nonspecific gastrointestinal symptoms and a history of travel to endemic areas. Early diagnosis and treatment are crucial to prevent complications and improve outcomes.
由寄生性血吸虫物种引起的血吸虫病是一种常见的被忽视的热带病，在包括苏丹在内的撒哈拉以南非洲地区流行。虽然尿路感染更为常见，但肠道血吸虫病却很罕见。该疾病表现为非特异性症状，常导致被误诊为炎症性肠病（IBD）。
一名来自苏丹杰济拉的23岁男性农民，出现间歇性血性腹泻和左下腹轻度疼痛6个月。尽管针对痢疾和IBD进行了多次诊断和治疗，但其症状仍持续存在。结肠镜检查显示直肠、乙状结肠、降结肠和横结肠黏膜水肿，有散在的白色斑点，升结肠和盲肠未见异常。活检证实为嗜酸性结肠炎伴血吸虫卵壳。患者接受吡喹酮治疗，症状在2周内得到缓解。
由曼氏血吸虫引起的血吸虫病通常表现为肌肉疼痛、发热和皮疹，同时伴有腹部症状。腹泻、腹痛、便秘和体重减轻很常见。粪便检查和血清学检测有助于诊断，但结肠镜检查可发现特征性表现，如黏膜水肿和血吸虫结节。早期诊断并用吡喹酮治疗对于预防并发症和改善患者预后至关重要。
该病例强调了在流行地区评估有结肠炎症状的患者时考虑血吸虫病的重要性。医疗保健提供者应对这种疾病保持高度怀疑指数，特别是对于有非特异性胃肠道症状且有疫区旅行史的患者。早期诊断和治疗对于预防并发症和改善预后至关重要。
