SHM Converge Scientific Abstract ePoster Gallery-Schistosomiasis Reactive Polyarthritis Masquerading as Seronegative Arthritis of Inflammatory Bowel Disease

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This case report describes an 18-year-old male refugee with 1 month of severe migrating joint pain affecting the knees, hips, lumbar spine, and foot, along with 5 days of hematochezia and low-grade fevers. Because his presentation included inflammatory back/joint symptoms plus bloody stool, he was initially evaluated for inflammatory bowel disease (IBD)–associated seronegative spondyloarthropathy/ulcerative colitis. Labs showed iron deficiency anemia and mild inflammatory marker elevation, while autoimmune tests were negative. Imaging and colonoscopy also suggested inflammatory bowel disease.<br /><br />However, his infectious exposure history was important: he had recently emigrated from Guinea and had lived in Nicaragua, both regions where parasitic infections may occur. Colonoscopy initially led to empiric steroid treatment for suspected ulcerative colitis, but this was stopped when GI PCR was positive for Entamoeba histolytica. He was treated with metronidazole and paromomycin. Final biopsy pathology then revealed Schistosoma ova in the colonic lamina propria with mild surrounding inflammation, and he subsequently received praziquantel.<br /><br />The authors conclude that schistosomiasis can present with reactive polyarthritis and may closely mimic seronegative arthritis associated with IBD. In patients with new inflammatory arthritis, hematochezia, and relevant travel or immigration history, infectious causes should be considered early to avoid misdiagnosis and inappropriate immunosuppressive therapy.

Asset Subtitle

Jiaxi Miao

Meta Tag

Author List Aesha Patel, Elmarie Alexander, George McKinley, Jiaxi Miao, Mark Alon, Rahul Gaikwad, Tara Sebastian, Zhuoran Yang

Category Clinical Vignettes

Concept Schistosomiasis

Concept Reactive Arthritis

Concept Migratory joint pain

Concept Colon biopsy

Concept Parasitic ova

Distinguished Non-Finalist

Presenter Organization Mount Sinai Morningside/West

Presenting Author Jiaxi Miao

Track Adult

Keywords

schistosomiasis

reactive polyarthritis

Entamoeba histolytica

hematochezia

inflammatory bowel disease

seronegative spondyloarthropathy

colonoscopy

praziquantel

metronidazole

refugee

Schistosomiasis

Reactive Arthritis

Migratory joint pain

Colon biopsy

Parasitic ova