What is the common clinical presentation of intestinal schistosomiasis caused by Schistosoma mansoni and japonicum?

• A. Chronic diarrhea with blood in stool and varying degrees of hepatosplenic involvement
• B. Acute fever and cough
• C. Severe dehydration without blood
• D. No GI symptoms

Answer: (A)

Intestinal schistosomiasis from Schistosoma mansoni and S. japonicum most often shows chronic gastrointestinal symptoms together with liver-related complications. The worms live in the mesenteric veins and lay eggs that become trapped in the intestinal wall, provoking a granulomatous inflammatory reaction. This leads to mucosal damage and bleeding, causing chronic diarrhea and blood in the stool. Over time, some eggs reach the liver and drive periportal inflammation and fibrosis, which can extend into the portal system and cause hepatosplenic involvement such as hepatomegaly, splenomegaly, and portal hypertension. While acute schistosomiasis (Katayama fever) can present with fever and cough, the question specifies the common presentation for intestinal forms, which is the chronic GI symptoms with hepatosplenic changes.