1/80. spinal cord schistosomiasis. A report of 2 cases and review emphasizing clinical aspects.Schistosomal myeloradiculopathy (SMR) is a severe and little known form of presentation of schistosomiasis mansoni and hematobic schistosomiasis. The literature concerning the entity is scarce, and most publications are limited to isolated case reports. Thus, to consolidate and analyze the knowledge currently available about the disease, I reviewed 231 cases, with emphasis on clinical aspects. Although variations occur, in most cases the clinical picture of SMR is highly suggestive in individuals with epidemiologic antecedents of the infection. Thus, a patient with SMR is usually a young male with no other manifestations of schistosomal infection who presents with lumbar pain, often of a radicular nature, soon followed by weakness and sensory loss of rapid progression in the lower limbs associated with autonomic dysfunction, particularly bladder dysfunction. The most suggestive elements of the entity, and therefore of higher diagnostic value, are the low localization of the spinal cord lesion, the acute or subacute onset of the disease, and the association of manifestations due to medullary and radicular involvement. SMR is commonly classified into clinical or anatomoclinical forms. However, I observed no consensus in this classification even in terms of the terminology used. The analysis performed in this review permitted the introduction of a new concept not yet reported in the literature regarding the possibility that the disease consists of a continuous spectrum, with asymptomatic egg laying in the spinal cord at 1 end of the spectrum and devastating forms at the other end, with most cases occupying an intermediate position and with the various types of damage overlapping and associated to different degrees. This concept applies not only to different patients but also to the same patient at different stages of the disease. Chemical and cytomorphologic examination of cerebrospinal fluid (CSF) almost always revealed mildly or moderately increased total protein concentration and predominantly lymphocytic pleocytosis. eosinophils, the least nonspecific finding, were detected in the CSF of less than half (40.8%) the patients. myelography and computed tomography-myelography were altered in 63.3% of cases, but this proportion may be an overestimate. The most frequent changes were images of a filling defect due to expansion of the spinal cord and were almost always demonstrated by the 2 imaging modalities. Although still few in number, early reports suggest that magnetic resonance imaging is more sensitive; however, the changes are also nonspecific, such as those revealed by myelography and computed tomography-myelography. Parasite eggs were demonstrated frequently in a biologic specimen (88.3%), but difficulty in detection was not uncommon. Peripheral blood eosinophilia was detected in 64.5% of patients and represented a nonspecific finding. The detection of anti-Schistosoma antibodies in the serum or CSF was also frequent (94.9% and 84.8%, respectively). The presence of anti-Schistosoma antibodies in serum is of limited value for the diagnosis of schistosomiasis in general, especially among individuals living in endemic areas; however, their quantification in the CSF has proved to be promising for diagnosis in the few studies conducted for this purpose. The large number of variables concerning treatment (such as drugs used and duration of disease at the beginning of treatment), together with the relative lack of information about the natural history of the disease, limit the analysis of aspects related to treatment and prognosis. Nevertheless, it was possible to conclude that corticosteroids and antischistosomotic drugs have a favorable effect on disease outcome and should be administered as early as possible. In addition to early treatment, factors linked to the disease itself affect prognosis. The new cases of SMR reported here are typical and illustrate the data discussed in this literature survey.- - - - - - - - - - ranking = 1keywords = schistosomiasis (Clic here for more details about this article) |
2/80. Detection of schistosoma mansoni in bronchoalveolar lavage fluid. A case report.BACKGROUND: Bronchoalveolar lavage (BAL) is a useful tool in the diagnosis of bacterial, viral, fungal and parasitic pulmonary infections. There have been rare reports of parasitic infestations in bronchoalveolar lavage fluid. This is the first case report on detecting a Schistosoma ova in BAL fluid. CASE: A 40-year-old, Egyptian male presented with a fever and productive cough. He had a right pleural effusion and segmental collapse of the right lower lobe. BAL fluid showed several ova of schistosoma mansoni and established the diagnosis of schistosomiasis. Abdominal ultrasound revealed mild hepatic cirrhosis. CONCLUSION: Schistosomiasis should be considered in the differential diagnosis of pulmonary problems in patients with disseminated disease in endemic areas.- - - - - - - - - - ranking = 0.14285714285714keywords = schistosomiasis (Clic here for more details about this article) |
3/80. Acute pulmonary schistosomiasis in travelers returning from Lake malawi, sub-Saharan africa.We describe four cases of acute schistosomiasis presenting to the Infectious Diseases Unit of John Radcliffe Hospital (Oxford, england) during a 2-month period in autumn 1997. All four patients had swum in Lake malawi, a freshwater lake in sub-Saharan africa that is associated with schistosoma haematobium and, less commonly, schistosoma mansoni infections. All four patients had a severe acute illness and had prominent pulmonary involvement, both clinically and radiologically. This represents a change in the recognized pattern of presentation and could possibly reflect a new parasite variant in the lake.- - - - - - - - - - ranking = 0.71428571428571keywords = schistosomiasis (Clic here for more details about this article) |
4/80. Late cutaneous schistosomiasis representing an isolated skin manifestation of schistosoma mansoni infection.Ectopic late cutaneous schistosomiasis is usually preceded or accompanied by visceral schistosomiasis infection. Our patient presented the very rare case of late cutaneous schistosomiasis as an isolated skin manifestation. Perigenital lesions occurred 1 year after contact with infested water. Identification of the few eggs remaining in the late lesion among the dense cellular infiltrate was difficult. Electron-microscopic studies clearly demonstrated the characteristic eggshell ultrastructure.- - - - - - - - - - ranking = 1keywords = schistosomiasis (Clic here for more details about this article) |
5/80. Schistosomal pelvic floor myopathy contributes to the pathogenesis of rectal prolapse in young males.PURPOSE: rectal prolapse is common in young males in egypt. The role of schistosomiasis in the pathogenesis of rectal prolapse is not clearly defined. The purpose of this work is to study changes in the pelvic floor muscles in patients of rectal prolapse associated with schistosomiasis. methods: This study included 33 male patients with rectal prolapse of whom 27 patients with schistosomiasis and 6 patients free from schistosomiasis. Biopsies were taken from the pelvic floor muscle during surgery. The prepared sections were examined for histopathologic structural changes, for ultrastructural changes (by using electron microscopy) and after immunohistochemical staining by using anti-IgG and anti-IgM antibodies. RESULTS: The muscles from the patients without schistosomiasis had no histologic or EM changes and showed negative staining for IgG and IgM. Myopathic changes were found in the group of patients with schistosomiasis, including increased variation in the fiber diameter in 66.6 percent of patients, degenerative changes in 59.26 percent of patients, fiber splitting and fragmentation in 44.4 percent of patients, and endomysial fatty changes in 55.5 percent of patients. Ultrastructural study revealed starting loss of striation and margination of the nucleus in 70.37 percent of patients, distorted myofibrillar pattern in 51.85 percent of patients, disturbed endoplasmic reticulum and increased glycogen granules in all patients, the mitochondria are irregularly arranged with electron dense matrix in 40.74 percent of patients, and prominent nuclear sap in 13.72 percent of patients. The muscles of all the schistosomal patients showed a positive cytoplasmic staining for immunoglobulin g, of them only 12 patients showed positive staining for IgM. CONCLUSION: patients with schistosomiasis suffer from pelvic floor myopathic changes that may contribute to the pathogenesis of rectal prolapse in young males. The immunohistochemical findings suggest immunologic mechanism for this myopathy.- - - - - - - - - - ranking = 1keywords = schistosomiasis (Clic here for more details about this article) |
6/80. Clinics in diagnostic imaging (52). spinal cord schistosomiasis.A 2-year-old Brazilian boy presented with bilateral leg weakness and constipation, followed by development of progressive paraparesis and bladder dysfunction. Neurological examination revealed flaccid paraparesis. blood tests and CSF analysis showed eosinophilia. The MR examination revealed a spinal cord mass extending from T9 to L1 levels, with a heterogeneously-enhancing solid component and a cystic component. Stool tests for schistosoma mansoni eggs were positive. The patient underwent surgery, the intramedullary mass was partially resected, and the diagnosis of spinal cord infection by schistosoma mansoni was confirmed. After surgery, the patient was treated with praziquantel and oxamniquine. He was discharged with partial improvement of the lower extremity weakness and bowel/bladder function. The clinical and imaging features of spinal cord schistosomiasis are reviewed.- - - - - - - - - - ranking = 0.71428571428571keywords = schistosomiasis (Clic here for more details about this article) |
7/80. schistosomiasis mansoni is associated with pyogenic liver abscesses in the state of Minas Gerais, brazil.The association between pyogenic liver abscesses and schistosomiasis has been confirmed by clinical and experimental studies. In this retrospective study of 78 patients with pyogenic liver abscesses the association with schistosomiasis has been investigated. Pyodermitis, a known focus of bacteremia, was observed in 19 patients (24%). blood eosinophilia was observed in 30 patients (39%). staphylococcus aureus was cultured from abscesses in 17 out of 38 patients (45%). Forty-one out of 57 patients (53%) had stool examination. schistosoma mansoni was the main parasite identified. eggs of S. mansoni were also identified in liver biopsies in 7 out of 19 patients who did the exam. The large number of young patients with liver abscesses described here is different from what has been observed in developed countries. This clinical study provide support for the concept that granulomas of S. mansoni in the liver are foci for colonization with S. aureus, which in presence of staphylococcal bacteremia can form liver abscesses.- - - - - - - - - - ranking = 0.28571428571429keywords = schistosomiasis (Clic here for more details about this article) |
8/80. 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.- - - - - - - - - - ranking = 1.2857142857143keywords = schistosomiasis (Clic here for more details about this article) |
9/80. 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.- - - - - - - - - - ranking = 0.57142857142857keywords = schistosomiasis (Clic here for more details about this article) |
10/80. 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.- - - - - - - - - - ranking = 0.14285714285714keywords = schistosomiasis (Clic here for more details about this article) |
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