BMJ Case Reports 2016; doi:10.1136/bcr-2016-216169

A fluke diagnosis

Editor's ChoicePress Release
  1. Simon Anderson3
  1. 1St Marks Hospital, London, UK
  2. 2Barnet General Hospital, London, UK
  3. 3Department of Gastroenterology, St Thomas’ Hospital, London, UK
  1. Correspondence to Dr Mark A Samaan, markasamaan{at}
  • Accepted 18 August 2016
  • Published 12 September 2016


A 42-year-old man presented to the emergency department with a 1-week history of left iliac fossa pain, fever and diarrhoea. He reported no recent travel or unwell contacts. He originated in Sierra Leone but has lived in the UK for 15 years. His last visit to Sierra Leone was 5 years ago.

On examination, left iliac fossa tenderness was noted with suspicion of a palpable mass. He was febrile, tachycardic and normotensive. Blood tests revealed an elevated C reactive protein of 120 mg/L and a white cell count of 15.7 (neutrophils 12.7)×106/mL. …

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