A routine case of suspected appendicitis in a young girl has revealed a far more serious and unexpected threat: a rare parasitic infection that had begun to attack her liver.
From Abdominal Pain to a Shocking Discovery
The patient, a 10-year-old girl who had migrated from Eritrea to Switzerland six months prior, was admitted to a local hospital with severe abdominal pain and vomiting. Doctors, assuming a case of appendicitis—a condition affecting 300,000 Americans annually—proceeded with standard tests and surgery to remove the inflamed organ.
However, during the operation, surgeons spotted several abnormal 'white spots' near the girl's liver. Analysis confirmed at least one contained a Schistosoma parasite. This worm, found in freshwater snails across parts of Africa, Asia, and South America, enters the human body through skin wounds.
A Silent Threat to Vital Organs
The parasite had caused the girl to contract schistosomiasis, an infection that can trigger flu-like symptoms but in her case had spread silently to her liver. It led to a condition called granulomatous hepatitis, which causes organ enlargement, scarring, and can ultimately result in liver failure.
Remarkably, the child showed no overt symptoms of the parasitic disease. Medical professionals believe that if she had not sought care for the appendicitis, the parasites could have caused irreversible damage to her liver before being detected. While Schistosoma can cause appendicitis, it remains unclear if this was the direct cause or a coincidence in her case.
A Global Health Issue Close to Home
This case highlights a significant public health consideration for receiving nations. Schistosomiasis is endemic in Eritrea, one of the world's least developed countries, where the girl is believed to have been infected. The CDC notes the disease is more common in regions lacking widespread sanitation and safe water programmes. Approximately 85% of global cases occur in Africa.
The situation in Switzerland is telling: a recent study found that 40% of newly arrived refugees from Eritrea tested positive for Schistosoma parasites. In the UK and similar non-endemic countries, cases are almost exclusively linked to travel or migration from affected areas.
The girl was successfully treated with two courses of the antiparasitic drug praziquantel, and her family was urged to undergo screening. Doctors do not expect lasting complications for her, thanks to the timely intervention.
In their report in the American Journal of Case Reports, her doctors concluded: "Taken together, these findings underscore the need for heightened clinical awareness and integrated screening in primary care as a cost-effective approach to managing schistosomiasis among migrants."
