- Flukes, invade skin of swimmers, enter blood stream→ can live in liver, bladder, bowel→ inflammation and fibrosis
- Intermediate host is snail.
- South America
- Middle East
- Swimming in infected waters
- Itching and erruption during first few days at site where enters skin
- Can cause peri-portal fibrosis, leading to portal htn after years
- Can live in bladder → SCC after years
- Might have weight loss
- Hepatomegaly, ascites, splenomegaly, edema, GI bleeding related to portal hypertension