Schistosomiasis in an HIV-Positive Patient Presenting as an Anal Fissure and Giant Anal Polyp

Gholam, Patrick; Autschbach, Frank; Hartschuh, Wolfgang

doi:10.1001/archderm.144.7.950

Cited by 6 publications

(3 citation statements)

References 7 publications

(12 reference statements)

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“…The present case is different from the anal polyp described by Carneiro et al 5 , as it is not associated with infections neither with HPV nor with HIV and from the giant anal polyp in a HIV-positive patient pointed out by Gohlan et al 7 .…”

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confidence: 82%

“…A case of condyloma acuminatum positive for human papiloma virus (HPV) with Schistosoma mansoni eggs in the lesion have been reported at the anal region of human imunudeficiency virus (HIV)-positive patient 6 as well as an association of anal fissure and a giant polyp with multiple calcified ova of Shistossoma mansoni, in Cameroonian woman, HIV-positive, living in Germany 7 . Moreover, a case of Shistossomal colonic polyposis has been described in a Ugandan man with advanced HIV-1 disease 8 .…”

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confidence: 99%

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Anal polyp caused by Schistosoma mansoni

Raso

Sander

Raso

et al. 2013

Rev. Soc. Bras. Med. Trop.

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We describe a schistosomal polyp in the anus of a 24-year-old patient, born in Viçosa, State of Minas Gerais, and living in Belo Horizonte, State of Minas Gerais. From 8 to 13 years of age, he swam in the rivers that bathe Viçosa. The histopathological examination has shown a lesion, lined by a keratinized squamous epithelium, ulcerated, with granulomas, centered or not by Schistosoma mansoni egg, laid, in loco, by the female present in the vascular lumen of a vein of the hemorrhoidal plexus. There was also a diffuse, nonspecific inflammation in the dermis. The patient was treated with praziquantel. Four months after the treatment, sigmoidoscopy showed a normal rectal mucosa, and negative oogram and stool tests. Ultrasound of abdomen was normal.

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confidence: 82%

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confidence: 99%

Anal polyp caused by Schistosoma mansoni

Raso

Sander

Raso

et al. 2013

Rev. Soc. Bras. Med. Trop.

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“…In more than 70 countries the infection is endemic with an estimated 660 million infections are concentrated in Africa, which accounts for 85% of the global at-risk estimated [ 1 – 3 ] Schistosoma can affect any site in the digestive tract, but the preferred site is the rectum while the sigmoid is rarely effected, and on occasion, it is found in the other parts of the large and small intestines. The polyp consists of a combination of a vascular neoformation and an inflammatory reaction to parasite eggs; worm can be found either dead or alive inside the polyp tissue [ 4 ] S. mansoni may be associated with the sexually transmitted disease as its eggs have been isolated from the condyloma acuminatum of patients with positive tests for human papillomavirus (HPV) in addition to human immunodeficiency virus (HIV) patients [ 5 , 6 ] .…”

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confidence: 99%

Colonic Polyps an Unusual Manifestation of Schistosomiasis

et al. 2020

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Patient: Male, 24-year-old Final Diagnosis: Large rectal polyps secondary to Schistosoma infection • Unusual colonic polyp caused by Schistoma infection Symptoms: Abdominal pain • bleeding per rectum Medication: During the procedure: Xylocaine local gel • Midazolam inj • Fentanyl inj; For the disease: Praziquantel tab Clinical Procedure: Colonoscopy with endoscopic submucosal resection (EMR) • endoscopic submucosal resection (EMR) Specialty: Gastroenterology and Hepatology • Endoscopy Objective: Report of misleading rare disease to avoid an unnecessary invasive intervention Background: Although reports of bilharizial colonic polyps are very rare in the literature, we report a case of a large rectal polyp as a manifestation of chronic intestinal bilharzia. A high index of suspicion in an endemic area is the key factor to avoid unnecessary medical interventions. Case Report: We report a case of a 24-year-old male patient who was married, born in Taiz North Yemen, and worked as a military soldier. He presented to our clinic with a complaint concerning intermittent lower abdominal pain and several months of rectal bleeding. A colonoscopy was performed at the Endoscopy Unit of King Khalid Hospital, Najran, Saudi Arabia on September 23, 2019 and results showed 2 large rectal polyps, (measuring 4×3 and 2×3 cm), located 10 cm from the anal verge, having wide bases and irregular surfaces that mimicked dysplastic polyps. Both polyps became elevated after a normal saline/methylene blue injection. An endoscopic mucosal resection was successfully performed with no immediate complications. The histopathology showed benign polyps due to Schistosoma -induced colonic infection. Conclusions: It is very difficult and challenging to differentiate Schistosoma -induced colonic polyps from other colonic polyps even with an endoscopic evaluation; thus, a high index of clinical suspicion is required mainly in an endemic area, which may prevent the physician from ordering unnecessary interventions and thus avoid severe complications.

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Inflammatory Disorders of the Anal Region

Winstanley

Novelli

2012

Morson and Dawson's Gastrointestinal Pathology

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Schistosomiasis in an HIV-Positive Patient Presenting as an Anal Fissure and Giant Anal Polyp

Cited by 6 publications

References 7 publications

Anal polyp caused by Schistosoma mansoni

Anal polyp caused by Schistosoma mansoni

Colonic Polyps an Unusual Manifestation of Schistosomiasis

Inflammatory Disorders of the Anal Region

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