A Diagnostic Pitfall: Chronic Schistosomiasis Presenting With Inflammatory Bowel Disease-Like Symptoms in an Endemic Area

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 <i>Schistosoma</i> ova, sessile polyps, and eosinophilic granulomas. The patient received 2400 mg of praziquantel and experienced complete resolution of symptoms.