In a study of individuals living in a subtropical region in which an irrigation project has been completed, it is noted that rice farmers have experienced an increased rate of an infectious illness since the project began. Investigators determined that the infection is acquired through cercariae that penetrate the skin. The cercariae are released from snails living in the irrigation canals. Infected individuals develop progressive ascites. Which of the following pathologic findings is most likely to be present in these infected individuals as a consequence of the infection?

Correct Answer: Hepatic fibrosis
Description: These farmers are infected with either Schistosoma mansoni or Schistosoma japonicum. Female worms reside in the portal venous system and release eggs that cut their way into the liver and incite a granulomatous inflammatory reaction. With time, the portal granulomas undergo fibrosis, compressing the portal veins. This gives rise to severe portal hypertension, splenomegaly, and ascites. A dilated cardiomyopathy may occur with Chagas disease, in which the Trypanosoma cruzi organisms are transmitted through the reduviid (triatomid) bug. Elephantiasis is a complication of filariasis, which is transmitted via mosquitoes. Mucocutaneous ulcers may be seen in Leishmania braziliensis infection, which is transmitted via sand flies. Squamous cell carcinomas may be seen in the bladder in chronic Schistosoma haematobium infection.
Category: Pathology
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