Schistosomal Cervical Myelopathy
Abstract Schistosomiasis is an infectious disease caused by trematode platyhelminths of the genus Schistosoma . The involvement of the cervical spinal cord is rare, with few cases reported in the literature. The management of such patients is particularly challenging, since clinical and radiological...
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Published in | Arquivos brasileiros de neurocirurgia Vol. 37; no. 2; pp. 151 - 153 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Rio de Janeiro, Brazil
Thieme Revinter Publicações Ltda
01.06.2018
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Subjects | |
Online Access | Get full text |
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Summary: | Abstract
Schistosomiasis is an infectious disease caused by trematode platyhelminths of the genus
Schistosoma
. The involvement of the cervical spinal cord is rare, with few cases reported in the literature. The management of such patients is particularly challenging, since clinical and radiological findings may be confounded with other inflammatory diseases and/ or spinal cord tumors. We describe a 20-year old male with a history of swimming outdoors. He first presented pain in the back of the neck extending to shoulders and upper limbs paresis associated with four limbs hyperreflexia. The magnetic resonance imaging (MRI) showed a hypointense T1-weighted lesion in the cervical spinal cord, which was hyperintense on T2 images. The serologic testing was negative for schistosomiasis. A cervical cord biopsy at the C5-C6 level showed
Schistosoma
eggs in the histopathological examination. The treatment was performed using a single dose of praziquantel 50 mg/kg, with prednisone 40 mg/day for 3 weeks. On the follow-up, 1 year later, the patient presented mild reduction of the vibratory sensitivity in the distal third of both legs. Our illustrative case strengthens that, in endemic regions,
Schistosoma mansoni
infestation should be included in the differential diagnosis of intramedullary expansive lesions. |
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ISSN: | 0103-5355 2359-5922 |
DOI: | 10.1055/s-0038-1661356 |