Schistosomiasis haematobium infections presenting as central nervous system lesions

Gottlieb, Frederick Jay

doi:10.1016/0002-9343(94)90055-8

Cited by 5 publications

(1 citation statement)

References 8 publications

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“…In some cases, an initial CT scan may reveal no abnormalities. A magnetic resonance imaging (MFU) scan was obtained in a patient and showed a homogeneous contrast-enhancing lesion with surrounding edema (27,56,107). In all reported cases of tumoral NS, the diagnosis was established with basis on the identification of eggs and granulomas in nervous tissue removed surgically or at autopsy.…”

Section: )mentioning

confidence: 99%

Neuroschistosomiasis

1997

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Schistosomiasis is an infection caused by digenetic trematode platyhelminths of the genus Schistosoma. These blood flukes use man and other mammals as definitive hosts and aquatic and amphibious snails as intermediate hosts. Of the schistosomal species, S. mansoni, S haematobium and S. japonicum are the most important to man and the most widely distributed. The infection affects about 200 million individuals in 74 countries of Latin America, Africa and Asia. Far less commonly, schistosomes reach the central nervous system (CNS). This may occur at any time from the moment the worms have matured and the eggs have been laid. For this reason, CNS involvement may be observed with any of the clinical forms of schistosomal infection. The presence of eggs in the CNS induces a cell-mediated periovular granulomatous reaction. When eggs reach the CNS during the early stages of the infection or during evolution of the disease to its chronic forms, large necrotic-exudative granulomas are found. In-situ egg deposition following the anomalous migration of adult worms appears to be the main, if not the only, mechanism by which Schistosoma may reach the CNS in these stages. The mass effect produced by the heavy concentration of eggs and the presence of large granulomas in circumscribed areas of the brain and spinal cord explains, respectively, 1) the signs and symptoms of increased intracranial pressure and focal neurological signs; and 2) the signs and symptoms of rapidly progressing transverse myelitis, usually affecting the lumbosacral segments of the spinal cord. Most of the cases of CNS involvement associated with the hepatosplenic and cardiopulmonary chronic forms, or with severe urinary schistosomiasis, though more frequent, are asymptomatic. In the patients with these clinical forms, the random and sparse distribution of eggs in the CNS indicates that the embolization of eggs from the portal mesenteric system to the brain and spinal cord constitutes the main route of CNS invasion by Schistosoma. The discrete inflammatory reaction elicited by the sparsely distributed eggs in the CNS explains the lack of neurological symptoms that could be produced by egg deposition.

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Section: )mentioning

confidence: 99%

Neuroschistosomiasis

1997

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Spinal cord schistosomiasis japonica: a report of 4 cases

2008

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Schistosomiasis in Swedish travellers to sub-Saharan Africa: can we rely on serology?

Thors

Holmblad

Maleki

et al. 2006

Scandinavian Journal of Infectious Diseases

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In the absence of egg excretion, laboratory diagnosis of recently acquired schistosomiasis is dependent on serology. 42 of 83 Swedish adventure tourists to sub-Saharan Africa had serum anti-schistosome antibodies indicating recent infection. There is little doubt regarding the specificity and sensitivity of serology for the demonstration of infection, but there is a need for alternative serological methods which could be more widely used than the standard immunofluorescence assay (IFA) for antibodies against gut-derived antigens (anti-GAA). We present results suggesting that 40/42 anti-GAA positive cases also react with keyhole limpet haemocyanin (KLH), a readily available commercial antigen. High anti-GAA titres were seen for more than 2 y despite treatment with praziquantel. Thus we are faced with several questions. How likely is it that positive serology means treatment failure? What is the risk involved in chronic infection? What is the prospect for monitoring treatment outcome by serology? We conclude that there is a need for better information on the risk of becoming infected, for improved methods for testing and for monitoring the therapeutic effects in adventure tourists.

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Schistosomiasis haematobium infections presenting as central nervous system lesions

Cited by 5 publications

References 8 publications

Neuroschistosomiasis

Neuroschistosomiasis

Spinal cord schistosomiasis japonica: a report of 4 cases

Schistosomiasis in Swedish travellers to sub-Saharan Africa: can we rely on serology?

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