The Brief Case: Acute Gangrenous Appendicitis with Incidental Schistosoma Eggs in a Malian Migrant.
Harold Bermúdez-Marval, José Sanz-Moreno, Elena Aguirregoicoa Garcia et al.
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Case in brief
A 28-year-old migrant from Mali presented with 24 hours of right lower abdominal pain, anorexia, and low-grade fever. Examination, inflammatory markers, and ultrasound supported acute appendicitis. Urgent laparoscopic appendectomy found a gangrenous, perforated appendix with localized exudate. Histology unexpectedly showed numerous Schistosoma ova throughout the appendiceal wall with eosinophilic granulomatous inflammation, consistent with chronic schistosomal infection alongside acute bacterial appendicitis. Recovery after surgery was uneventful, but transfer of care prevented local administration of definitive antiparasitic therapy.
What made this case unusual
Schistosoma ova were an unexpected histopathological finding in a gangrenous, perforated appendix, revealing chronic infection in a nonendemic setting.
Diagnostic / clinical pearl
In migrants from schistosomiasis-endemic regions, appendectomy histology may reveal parasitic infection not suspected from the acute presentation; correlate pathology with clinical and epidemiological context.
Why it matters
The report emphasizes coordination among clinicians, surgeons, pathologists, and microbiologists to support accurate diagnosis and appropriate management.