Schistosomal Colitis as an Uncommon Cause of Hematochezia in a School-Aged Boy: A Case Report

Schistosomiasis is a neglected tropical disease with clinical presentations that vary depending on the species involved. Schistosomal colitis is a rare manifestation, with few cases documented in the literature. We report a case of a 9-year-old boy presenting with painless hematochezia and a history of residence in a schistosomiasis-endemic region. Colonoscopy revealed evidence of colitis, and histopathological examination of colon biopsy confirmed schistosomal ova with eosinophilic infiltration in the colonic mucosa. The patient responded well to treatment with oral Praziquantel (40 mg/kg). This case underscores the need for a high index of suspicion and the inclusion of tropical diseases in the differential diagnosis when evaluating patients with lower gastrointestinal bleeding, particularly in endemic areas. Pediatric schistosomal colitis in Africa represents a clinically significant yet often underdiagnosed manifestation of Schistosomiasis, highlighting the need for heightened awareness of its distinctive gastrointestinal presentations, diagnostic challenges, and implications for early intervention in children living in endemic regions.