An Unusual Case of Schistosomiasis Mimicking Colon Malignancy: Diagnostic Conundrum

Schistosomiasis remains a rare and underdiagnosed trematode parasitic infection in the Indian subcontinent. We present a case of a 52-year-old diabetic patient, suspected to have colonic cancer with altered bowel habits and occasional rectal bleeding symptoms. Radiological findings of contrast-enhanced computed tomography(CECT) suggested colonic malignancy, while all other malignancy workups were negative. Colonoscopic biopsy findings revealed non-specific colitis, indicating high suspicion towards parasitic foci. Few Schistosoma mansoni ova were found after direct stool microscopy, leading to[PP1] the diagnosis of Schistosomiasis. The patient was treated with albendazole along with praziquantel and showed marked clinical improvement. Radiologically, intestinal schistosomiasis may resemble other gastrointestinal disorders, like colonic neoplasms. This case highlights the need for clinicians and microbiologists to maintain a high index of suspicion for schistosomiasis in patients exhibiting colonic lesions, aided by accurate microbiological tests such as stool microscopy, particularly in underdiagnosed areas.