Parasites, Hosts and Diseases

The Korea Society for Parasitology and Tropical Medicine (대한기생충학·열대의학회)
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Cerebellar Schistosomiasis: A Case Report with Clinical Analysis

  • Wan, Heng (Department of Neurology and Functional Neurosurgery, West China Fourth Hospital of Sichuan University) ;
  • Lei, Ding (Department of Neurosurgery, West China Hospital of Sichuan University) ;
  • Mao, Qing (Department of Neurology, Huashan Hospital of Fudan University)
  • Published : 2009.03.31
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Abstract

The authors report here a rare case of cerebellar schistosomiasis identified by pathological diagnosis, lacking extracranial involvement. The clinical symptoms included headache, dizziness, and nausea. Studies in blood were normal and no parasite eggs were detected in stool. Computed tomography of brains showed hypodense signal, and magnetic resonance imaging showed isointense signal on T1-weighted images, hyperintense signal on T2-weighted images, and intensely enhancing nodules in the right cerebellum after intravenous administration of gadolinium. A high-grade glioma was suspected, and an operation was performed. The pathologic examination of the biopsy specimen revealed schistosomal granulomas scattered within the parenchyma of the cerebellum. The definitive diagnosis was cerebellar schistosomiasis japonica. A standard use of praziquantel and corticosteroid drugs was applied, and the prognosis was good. When the pattern of imaging examinations is present as mentioned above, a diagnosis of brain schistosomiasis should be considered.

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References

  1. Mao SP, Shao BR. Schistosomiasis control in the People's Republic of China. Am J Trop Med Hyg 1982; 31: 92-99
  2. Zhou D, Li YS, and Yang X. Schistosomiasis control in China. World Health Forum 1994; 15: 387-389
  3. Ross AG, Sleigh AC, Li Y, Davis GM, Williams GM, Jiang Z, Feng Z, McManus DP. Schistosomiasis in the People’s Republic of China:prospects and challenges for the 21st century. Clin Microbiol Rev 2001; 14: 270-295 https://doi.org/10.1128/CMR.14.2.270-295.2001
  4. Lee YK, Choi TY, Jin SY, Lee DW. Imported CNS schistosomiasisa case report. J Korean Med Sci 1995; 10: 57-61
  5. Schils J, Hermanus N, Flament-Durant J, Van Gansbeke D, Baleriaux D. Cerebral schistosomiasis. AJNR Am J Neuroradiol 1985; 6: 840-841
  6. Nascimento-Carvalho CM, Moreno-Carvalho OA. Clinical and cerebrospinal fluid findings in patients less than 20 years old with a presumptive diagnosis of neuroschistosomiasis. J Trop Pediatr 2004; 50: 98-100 https://doi.org/10.1093/tropej/50.2.98
  7. Lambertucci JR. Acute schistosomiasis: clinical, diagnostic and therapeutic features. Rev Inst Med Trop Sao Paulo 1993; 35: 399-404
  8. Ching HT, Clark AE, Hendrix VJ, Kobrine AI, Schwartz AM. MR imaging appearance of intracerebral schistosomiasis. AJR Am J Roentgenol 1994; 162: 693-694 https://doi.org/10.2214/ajr.162.3.8109523
  9. Richards FJr, Sullivan J, Ruiz-Tiben E, Eberhard M, Bishop H. Effect of praziquantel on the eggs of Schistosoma mansoni with a note on the implications for managing central nervous system schistosomiasis. Ann Trop Med Parasitol 1989; 83: 465-472
  10. Watt G, Adapon B, Long GW, Fernando MT, Ranoa CP, Cross JH. Praziquantel in treatment of cerebral schistosomiasis. Lancet 1986; 2: 529-532 https://doi.org/10.1016/S0140-6736(86)90110-8

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