Rectal Bleeding After River Baths

A 29-year-old man presents with rectal bleeding. His history of bathing in rivers in Brazil and lab findings of Eosinophilia point to a surprising diagnosis.

Praziquantel


A 29-year-old man presented to the outpatient clinic with 2 months of bright red blood from the rectum. He had no fever, weight loss, diarrhea, or hematuria. He lived in the interior of northeastern Brazil and regularly bathed in rivers. On physical examination, he had slight tenderness to palpation of the left flank. Laboratory testing was notable for an absolute eosinophil count of 470 per cubic millimeter (reference range, 34 to 420). A colonoscopy identified a reddish, polypoid lesion in the distal rectum. Biopsy of the lesion revealed a dense inflammatory infiltrate containing eosinophils and schistosome eggs. What is the appropriate treatment for this condition?

What is the most likely diagnosis?

Itraconazole
Ivermectin
Metronidazole
Nitazoxanide
Praziquantel

Eosinophilia, Infectious Colitis, Praziquantel, Rectal Bleeding, Schistosomiasis

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