[Peranal bleeding and elevated liver function tests in a 33‑year-old refugee from Nigeria].

A 33-year-old refugee from Nigeria, who had been living in Germany for 1 year, was admitted to the hospital due to pelvic pain, peranal hemorrhage, and an unexplained increase in transaminase levels. As the liver screening tests, sonography findings, and colonoscopy were normal, a liver biopsy was performed that revealed Schistosoma mansoni worm eggs as an unexpected diagnostic finding. Serological tests for specific antibodies and parasitological egg detection in the stool confirmed the diagnosis. After only temporary response to a short-term and low-dose treatment with praziquantel, a 3-day high-dose (40 mg/kg body weight) treatment with praziquantel finally led to long-lasting symptom relief.