{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T05:03:28Z","timestamp":1779253408849,"version":"3.51.4"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Schistosomiasis remains an important public health challenge in Egypt despite decades of control programs. Intestinal involvement is relatively common but usually presents with diffuse mucosal disease, ulcerations, or multiple polyps. A solitary bleeding rectal polyp as the sole manifestation is exceedingly rare and can be mistaken for inflammatory bowel disease or colorectal neoplasia. This report aims to highlight this diagnostic challenge within the Egyptian context.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>\n                      A 28-year-old Egyptian male from a rural area presented with a 3-month history of intermittent lower abdominal pain and rectal bleeding. Physical examination was unremarkable except for mild lower abdominal tenderness and blood on digital rectal exam. Laboratory tests, including inflammatory markers, were normal; notably, stool microscopy was repeatedly negative for schistosome ova, despite the presence of RBCs and WBCs. Colonoscopy identified a solitary, pedunculated, and ulcerated rectal polyp (1.5\u2009\u00d7\u20093.0 cm) at 20 cm from the anal verge, which was completely resected. Histopathological examination confirmed the diagnosis by demonstrating viable\n                      <jats:italic>Schistosoma mansoni<\/jats:italic>\n                      ova within eosinophilic granulomas and, critically, an adult worm residing in the submucosal vasculature, confirming active infection.The patient achieved full clinical recovery after praziquantel therapy, and this case underscores the importance of integrating parasitological, endoscopic, and histopathological perspectives when managing atypical colorectal lesions in endemic regions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case is a striking example of intestinal schistosomiasis masquerading as a sporadic colorectal neoplasm. In endemic regions like Egypt, schistosomiasis must be considered in the differential diagnosis of solitary rectal polyps, even with negative stool examinations. The definitive diagnosis hinges on histopathological analysis, which is indispensable for guiding correct management and avoiding unnecessary interventions. This report reinforces the ongoing, evolving challenge of schistosomiasis in Egypt post-control programs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0013972","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T18:31:42Z","timestamp":1770661902000},"page":"e0013972","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Bleeding rectal polyp as an atypical presentation of intestinal schistosomiasis: A case report from Egypt"],"prefix":"10.1371","volume":"20","author":[{"given":"Mohamed M.","family":"Elhoseeny","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Sallam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed E.","family":"Eladl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8191-0035","authenticated-orcid":true,"given":"Amira A. A.","family":"Othman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"issue":"9936","key":"pntd.0013972.ref001","doi-asserted-by":"crossref","first-page":"2253","DOI":"10.1016\/S0140-6736(13)61949-2","article-title":"Human schistosomiasis","volume":"383","author":"DG Colley","year":"2014","journal-title":"Lancet"},{"issue":"5","key":"pntd.0013972.ref002","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.jare.2012.12.001","article-title":"Hepatic and intestinal schistosomiasis: review","volume":"4","author":"T Elbaz","year":"2013","journal-title":"J Adv Res"},{"issue":"1","key":"pntd.0013972.ref003","article-title":"Persistent Colonic Schistosomiasis among Symptomatic Rural Inhabitants in the Egyptian Nile Delta","volume":"13","author":"MH Ahmed","year":"2021","journal-title":"Mediterr J Hematol Infect Dis"},{"issue":"1","key":"pntd.0013972.ref004","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/s40249-020-00648-9","article-title":"Elimination of schistosomiasis requires multifactorial diagnostics: evidence from high- and low-prevalence areas in the Nile Delta, Egypt","volume":"9","author":"H Elmorshedy","year":"2020","journal-title":"Infect Dis Poverty"},{"key":"pntd.0013972.ref005","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.actatropica.2018.08.024","article-title":"Elimination of schistosomiasis haematobia as a public health problem in five governorates in Upper Egypt","volume":"188","author":"AA Haggag","year":"2018","journal-title":"Acta Trop"},{"issue":"1","key":"pntd.0013972.ref006","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1128\/CMR.12.1.97","article-title":"Relationship between schistosomiasis and bladder cancer","volume":"12","author":"MH Mostafa","year":"1999","journal-title":"Clin Microbiol Rev"},{"issue":"11","key":"pntd.0013972.ref007","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1111\/j.1365-3024.2009.01157.x","article-title":"Schistosomiasis and liver fibrosis","volume":"31","author":"ZA Andrade","year":"2009","journal-title":"Parasite Immunol"},{"issue":"9541","key":"pntd.0013972.ref008","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1016\/S0140-6736(06)69440-3","article-title":"Human schistosomiasis","volume":"368","author":"B Gryseels","year":"2006","journal-title":"Lancet"},{"issue":"1","key":"pntd.0013972.ref009","doi-asserted-by":"crossref","first-page":"12","DOI":"10.3748\/wjg.v6.i1.12","article-title":"Schistosomiasis: progress and problems","volume":"6","author":"GY Wu","year":"2000","journal-title":"World J Gastroenterol"},{"issue":"6","key":"pntd.0013972.ref010","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.4269\/ajtmh.1955.4.1057","article-title":"Recto sigmoid polyps in schistosomiasis. I. General clinical and pathological considerations","volume":"4","author":"RM Dimmette","year":"1955","journal-title":"Am J Trop Med Hyg"},{"issue":"26","key":"pntd.0013972.ref011","doi-asserted-by":"crossref","first-page":"4156","DOI":"10.3748\/wjg.v29.i26.4156","article-title":"Schistosomal (bilharzial) polyps: Travel through the colon and beyond","volume":"29","author":"MH Emara","year":"2023","journal-title":"World J Gastroenterol"},{"issue":"6","key":"pntd.0013972.ref012","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1055\/s-2005-861352","article-title":"Update on the paris classification of superficial neoplastic lesions in the digestive tract","volume":"37","author":"Group Endoscopic Classification Review","year":"2005","journal-title":"Endoscopy"},{"key":"pntd.0013972.ref013","volume-title":"Theory and practice of histological techniques","author":"JD Bancroft","year":"2008","edition":"6"},{"key":"pntd.0013972.ref014","volume-title":"Schistosomiasis: progress report 2001\u20132011, strategic plan 2012\u20132020","author":"World Health Organization","year":"2013"},{"issue":"1","key":"pntd.0013972.ref015","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s12876-020-01591-7","article-title":"The clinical features of chronic intestinal schistosomiasis-related intestinal lesions","volume":"21","author":"X Qin","year":"2021","journal-title":"BMC Gastroenterol"},{"key":"pntd.0013972.ref016","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1186\/1752-1947-8-331","article-title":"Schistosomiasis manifesting as a colon polyp: a case report","volume":"8","author":"I Issa","year":"2014","journal-title":"J Med Case Rep"},{"key":"pntd.0013972.ref017","article-title":"Colonic Polyps an Unusual Manifestation of Schistosomiasis","volume":"21","author":"AM Al-Zubaidi","year":"2020","journal-title":"Am J Case Rep"},{"issue":"6","key":"pntd.0013972.ref018","doi-asserted-by":"crossref","first-page":"705","DOI":"10.4103\/NJM.NJM_92_22","article-title":"Intestinal schistosomiasis with colonic polyps","volume":"31","author":"N David","year":"2022","journal-title":"Niger J Med"},{"key":"pntd.0013972.ref019","first-page":"379","article-title":"Huge Colonic Granuloma of Schistosomiasis Mimicked Cancer in a 10-Years-Old Child: A Case Report","volume":"15","author":"Q Alyhari","year":"2022","journal-title":"Int Med Case Rep J"},{"issue":"1","key":"pntd.0013972.ref020","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1186\/s12879-021-06125-4","article-title":"Intestinal schistosomiasis masquerading as intestinal polyps","volume":"21","author":"XL Zhu","year":"2021","journal-title":"BMC Infect Dis"},{"issue":"3","key":"pntd.0013972.ref021","doi-asserted-by":"crossref","DOI":"10.1016\/S1473-3099(23)00486-3","article-title":"Chronic intestinal schistosomiasis caused by co-infection with Schistosoma intercalatum and Schistosoma mansoni","volume":"24","author":"P Ko\u0142odziej","year":"2024","journal-title":"Lancet Infect Dis"},{"issue":"4","key":"pntd.0013972.ref022","doi-asserted-by":"crossref","DOI":"10.1016\/S2666-5247(23)00377-4","article-title":"Diagnostic tests for human Schistosoma mansoni and Schistosoma haematobium infection: a systematic review and meta-analysis","volume":"5","author":"MT Vaillant","year":"2024","journal-title":"Lancet Microbe"},{"issue":"2","key":"pntd.0013972.ref023","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1556\/1886.2024.00013","article-title":"Insights into the epidemiology, pathogenesis, and differential diagnosis of schistosomiasis","volume":"14","author":"E Ponzo","year":"2024","journal-title":"Eur J Microbiol Immunol (Bp)"},{"key":"pntd.0013972.ref024","author":"IR Mulei","year":"2010"},{"key":"pntd.0013972.ref025","doi-asserted-by":"crossref","first-page":"983","DOI":"10.2147\/IJGM.S391017","article-title":"Advances in Diagnosis of Schistosomiasis: Focus on Challenges and Future Approaches","volume":"16","author":"B Chala","year":"2023","journal-title":"Int J Gen Med"},{"issue":"1","key":"pntd.0013972.ref026","doi-asserted-by":"crossref","first-page":"15115","DOI":"10.1038\/s41598-023-42456-9","article-title":"Clinicopathological characteristics and its association with digestive system tumors of 1111 patients with Schistosomiasis japonica","volume":"13","author":"Y Yang","year":"2023","journal-title":"Sci Rep"},{"issue":"8","key":"pntd.0013972.ref027","doi-asserted-by":"crossref","first-page":"4895","DOI":"10.1097\/MS9.0000000000002300","article-title":"Schistosomal colitis mimicking inflammatory bowel disease: a case report from Sudan","volume":"86","author":"MB Alajab","year":"2024","journal-title":"Ann Med Surg (Lond)"},{"issue":"3","key":"pntd.0013972.ref028","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1097\/PAS.0000000000001594","article-title":"Clinicopathologic features of chronic intestinal schistosomiasis and its distinction from Crohn d\u00a0\u00a0\u00a0\u00a0isease","volume":"45","author":"L Cai","year":"2020","journal-title":"Am J Surg Pathol"},{"issue":"8","key":"pntd.0013972.ref029","doi-asserted-by":"crossref","first-page":"472","DOI":"10.4253\/wjge.v16.i8.472","article-title":"Colonic schistosomiasis mimicking cancer, polyp, and inflammatory bowel disease: Five case reports and review of literature","volume":"16","author":"ST Mulate","year":"2024","journal-title":"World J Gastrointest Endosc"}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013972","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T18:31:46Z","timestamp":1770661906000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013972"}},"subtitle":[],"editor":[{"given":"Sarman","family":"Singh","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,2,9]]},"references-count":29,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,9]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0013972","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,9]]}}}