SCHISTOSOMAL MYELORADICULOPATHY IN A NON-ENDEMIC AREA

• Published in: Revista Paulista de Pediatria Vol. 38; p. e2018232
• Main Authors: Oliveira, Lívia Souza de, Kuzma, Gabriela de Sio Puetter, Costa, Luisa Carolina Vinhal, João, Paulo Ramos David
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade de Pediatria de São Paulo 01.01.2020
• Subjects: Adolescent; Case Report; Myelitis; Neuroschistosomiasis; Schistosomiasis mansoni
• ISSN: 0103-0582; 1984-0462
• DOI: 10.1590/1984-0462/2020/38/2018232

To report a schistosomal myeloradiculopathy case in a non-endemic area. A previously healthy 11-year-old boy, stricken by an acute loss of strength on his lower limbs, followed by a loss of strength on his upper limbs and upper body, associated with altered sensitivity of the vesical globe formation. The patient's cerebrospinal fluid analysis showed eosinophilic meningitis, in addition to peripheral eosinophilia. The investigation resulted in a positive serology for Schistosoma mansoni. The treatment included steroids and praziquantel 60mg/kg, with a new dose after a month, as well as physical therapy for rehabilitation. The patient evolved with clinical improvement in the neurological exam, with a medullary section initially at C6, but now at T6. The patient is kept at prednisolone use (30mg/day) and longterm urinary catheter dependence. The schistosomiasis is endemic in many regions of Brazil; however, it has low incidence in the south of the country. Among its main manifestations, the schistosomal myeloradiculopathy is the most severe ectopic form of the disease, and should be suspected in patients with low back pain, strength and/or sensibility disorder of the lower limbs or urinary tract's disturbance. Early diagnosis and treatment should be done in order to reduce severe neurological sequelae. Treatment includes schistosomiasis drugs, corticosteroids and/or surgery.