Calcified eggs are present in the lamina propria indicating remote infection and typically do not elicit any inflammatory reaction. In an active infection, however, one would except a vigorous granulomatous inflammation with abundant eosinophils, inflammatory polyps and/or mucosal ulcers (1).

Another image of a calcified schistosome

Endoscopic image of chronic schistosomiasis infection.

Schistosoma (also called bilharzia after the man who first described this illness) can affect any part of the GI tract and is endemic in Africa, Asia, South America (mainly tropical countries). Different species are predominant in a country. Schistosoma species are flukes that require snails as intermediate hosts.

Patients with an active infection will have bloody diarrhea, anemia and weight loss. The disease may also have a more serious presentation (e.g. obstruction, perforation, dysentery-like illness). If accompanied by cirrhosis (also a manifestation of schistosoma infection), there may be portal hypertension and varices along the GI tract (1).

Antiparasitic medications