11/107. Concomitant prostatic schistosomiasis and adenocarcinoma: case report and review. The term schistosomiasis encompasses a group of infectious disorders caused by five species of the genus Schistosoma, a blood trematode of outstanding importance in tropical areas. Some of these disorders have long been associated with malignant neoplasia, the most striking association being between disease caused by schistosoma haematobium, the predominant etiological agent of urinary schistosomiasis, and squamous cell carcinoma of the bladder, a relatively uncommon vesical cancer in non-endemic areas. Four cases of simultaneous adenocarcinoma and schistosomiasis of the prostate have been previously reported (S. haematobium in three and S. mansoni in one). We report a fifth case of concomitant adenocarcinoma and schistosomiasis of the prostate in a 68-year-old Brazilian patient infected with S. mansoni. We also review the medical literature on the association between schistosomiasis and cancer. ( info) |
12/107. spinal cord schistosomiasis in children: analysis of seven cases. We describe seven cases of children (ages 2 to 14 years) with myeloradiculopathy caused by infection with S. mansoni. None of them presented hepatosplenic involvement and one presented an intestinal picture. The myeloradicular and pseudotumoral forms were observed in four and three patients, respectively. Comparing the reports in the literature, we found that the pseudotumoral form is more similarly frequent among children than in adults, while the myelitic and myeloradicular forms are the most frequent and distributed across all age groups. Diagnosis is based on clinical and epidemiological findings in association with laboratory tests. The diagnosis was confirmed by the presence of S. mansoni eggs in feces (5 cases) and / or the positivity in specific immunological tests (5 cases) associated with a cerebrospinal fluid inflammatory pattern with presence of eosinophils (between 1 and 24%). Magnetic resonance image, although it does not enable an etiological diagnosis, helped to confirm the form and spinal cord level of the lesion. ( info) |
13/107. schistosoma mansoni myeloradiculopathy in an 8-year-old Omani boy. An 8-year-old Omani boy presented with progressive ascending weakness of the lower limbs with bowel and bladder incontinence. A diagnosis of myeloradiculopathy was made on neurologic examination. eosinophilia in the peripheral blood count and suspected endemicity in his region of residence raised the diagnostic possibility of neuroschistosomiasis. cerebrospinal fluid findings, high schistosoma antibody titre, magnetic resonance imaging of the spine, and detection of schistosoma mansoni eggs in the stool confirmed the diagnosis. The boy recovered significantly after receiving praziquantel and methylprednisolone. Neurological symptoms at presentation could be due to parasitic infection and should be considered in an endemic region. eosinophilia in the peripheral blood count may be the first indicator. ( info) |
14/107. Treatment by splenectomy of a portal vein aneurysm in hepatosplenic schistosomiasis. portal vein aneurysm is a rare medical entity that can be caused by chronic hepatic diseases with portal hypertension. We describe a 45-year-old man with variceal bleeding from hepatosplenic schistosomiasis and an incidentally found intrahepatic aneurysm. Diagnosis was confirmed with non-invasive imaging exams, arteriography and liver biopsy. Following splenectomy, the aneurysm diameter decreased substantially. ( info) |
| Portopulmonary hypertension syndrome (PPHS) is a complication of portal hypertension where the substrate is micro-vessel lesions which are indicative of plexogenic arteriopathy. PPHS has not been linked to pulmonary schistosomiasis. We report, to the best of our knowledge for the first time, a case of PPHS associated with schistosomiasis mansoni. ( info) |
16/107. Recurrent nonvariceal upper gastrointestinal bleeding in a patient with gastroduodenal schistosomiasis. In this case report, we describe the rare situation of a patient with nonvariceal upper gastrointestinal bleeding induced by gastric and duodenal involvement of schistosoma mansoni infection. In this unique case severe, recurrent upper gastrointestinal bleeding was induced by central ulcerations of gastric pseudopolypoid and duodenal polypoid lesions. However, very atypically, there were no signs of portal hypertension, coagulopathy, or variceal bleeding, and no macroscopic evidence of lower gastrointestinal tract involvement. Neither anti-ulcer therapy nor endoscopic hemostasis methods were effective in preventing recurrent bleeding episodes. Finally, typical histological and serological tests (positive for S. mansoni hemagglutination) led to the correct diagnosis, and the patient was completely cured by specific antischistosomal therapy. ( info) |
17/107. Schistosomiasis of the uterus in a patient with dysmenorrhoea and menorrhagia. Abdominal hysterectomy was performed in a patient because of complaints of dysmenorrhoea and menorrhagia and the uterus was sent for histopathological analysis. Besides adenomyosis an extensive granulomatous infection with schistosoma mansoni eggs was found. ( info) |
18/107. Intramedullary schistosomiasis. A case study of intramedullary schistosomiasis in a 10-year-old child is reported. The patient presented with a short history of ascending paraparesis with no sensory loss. Sphincter dysfunction was rapid. She had surgical exploration and removal of a conus medullaris mass. Schistosomiasis was confirmed histologically. Combined steroid and praziquantel therapy improved her sphincter function and paraparesis. ( info) |
19/107. Case report: schistosoma mansoni infection: failure of standard treatment with praziquantel in a returned traveller. Heavy reliance upon praziquantel for the treatment of schistosomiasis raises concerns over potential development of drug resistance. We describe a British traveller who acquired schistosoma mansoni infection in East africa and in whom repeated standard 40 mg/kg doses of praziquantel failed to clear the infection despite no opportunity for reinfection. ( info) |
| The case of a 21-year-old man coming from rural Paraiba, northwestern brazil, with schistosomiasis mansoni associated with serratia marcescens bacteremia, is reported. His main complaints on admission were fever, diaphoresis and chills for ten days, and diarrhoea that lasted for four days. On physical examination he had jaundice and hepatosplenomegaly. Diagnosis of S. marcescens bacteremia was made by isolation of the bacterium in blood culture, and schistosomiasis was diagnosed by rectal and liver biopsies. This is the first time that the association of S. marcescens bacteremia and schistosomiasis mansoni is recognized. Although our case does not fit into the classic definition of prolonged bacteremia associated with schistosomiasis, it can be considered as a mild form of this association. With the improvement of medical assistance and laboratory facilities, early diagnosis of this association will be made more frequently, cases with short duration will be diagnosed few days after the start of the symptoms, and classic prolonged cases will become rarer. ( info) |