This patient has schistosomiasis infection. Treatment with Praziquantel is usually effective. Schistosomiasis is more commonly found in endemic areas such as Africa and Far East. Humans are infected initially when cercariae found in fresh water bore through the skin, usually the feet. Transmission of the disease cannot occur in the UK, because of the lack of suitable snail hosts.Initial infection may not be noticeable like in this patient. Diagnosis is made by identification of ova in stool or ELISA. However ELISA cannot differentiate between new or old infection.