Schistosomal colitis without granuloma formation in a kidney transplant recipient.

BACKGROUND

A 40-year-old male from the White Nile region in Sudan, who had received a kidney transplant 6 years previously, presented with fever, lower abdominal pain and diarrhea stained with blood of 5 months duration. He was on immunosuppressive maintenance therapy, consisting of ciclosporin 75 mg twice daily, prednisolone 10 mg once daily, and azathioprine 75 mg once daily.

INVESTIGATIONS: Laboratory investigations, liver function tests, renal function tests, stool microscopy, stool culture, abdominal ultrasound, and colonoscopy.

DIAGNOSIS: Severe, left-sided colitis due to Schistosoma mansoni infection, without granuloma formation.

MANAGEMENT: Oral antischistosomal therapy with praziquantel at a dose of 40 mg/kg body weight.