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Schistosomiasis, an Unusual Cause of Variceal Bleeding in the United States

Batra, Vivek MD*; Fichtenbaum, Carl J. MD; Giannella, Ralph A. MD

Infectious Diseases in Clinical Practice: March 2013 - Volume 21 - Issue 2 - p 133–135
doi: 10.1097/IPC.0b013e3182604dd8
Case Reports

We present the case of a 38-year-old man from Africa who presented to our hospital with melena. After workup, he was found to have noncirrhotic portal hypertension from schistosomiasis. He required multiple banding procedures to control variceal bleeding. Worldwide, this disease is epidemic in Africa, Asia, and South America; but in the United States, only a few cases are seen in tertiary centers, mainly in immigrants from these nations. This case illustrates that complications of chronic hepatic schistosomiasis are treatable, and clinicians should have a broad differential when providing care to patients from outside the United States.

This case report highlights that schistosomiasis is a rare cause of variceal bleeding and non-cirrhotic portal hypertension in the United States. Physicians should consider this disease as part of the differential for gastrointestinal bleeding, especially in immigrants from areas where this disease is highly prevalent.

From the *Department of Internal Medicine, †Division of Infectious Diseases and ‡Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, OH.

Correspondence to: Vivek Batra, MD, Department of Internal Medicine, University of Cincinnati Medical Center, 231 Albert B. Sabin Way, PO Box 670557, Cincinnati, OH 45267-0557. E-mail:

The authors have no funding or conflicts of interest to disclose.

© 2013 by Lippincott Williams & Wilkins.