Schistosomal appendicitis: a case report

Abstract

Background: Schistosomiasis is one of the endemic parasitic diseases in many developing countries. Despite this, appendicitis secondary to schistosomiasis is an uncommon condition even in some endemic areas. Schistosomal appendicitis, an incidentally discovered appendicitis associated with schistosomiasis histological findings, affects young males predominantly. Timely diagnosis and treatment, including appendectomy and anti-helminthic therapy, are crucial.

Case report: A 24-year-old Sudanese male patient presented with abdominal pain. Diagnosed with acute appendicitis, he underwent appendectomy, revealing appendix inflammation with Schistosoma ova in histopathology. Abdominal ultrasound detected no complications. Weakly positive Schistosoma serology was noted, but stool and urine analysis showed no infection evidence. Prescribed praziquantel, patient had 3-year post-op follow-up without complications.

Conclusions: This case report underscores the significance of including schistosomiasis in the differential diagnosis of appendicitis, particularly in regions where the disease is endemic. It underscores the necessity of histopathological evaluations for accurate diagnosis, emphasizing the potential implications for clinical practice in similar settings.

Keywords: Schistosoma ova; Acute appendicitis; Bilharziasis; Schistosomal appendicitis.

Fig. 1

Removed appendix

Fig. 2

Multiple calcified and viable Schistosoma ova surrounded by moderate inflammation in submucosa of appendix

Fig. 3

Serosal involvement by viable Schistosoma ova

Fig. 4

Higher power shows marked inflammatory infiltrate composed mainly of eosinophils surrounding Schistosoma ova