Spinal cord schistosomiasis: A case report
摘要
Schistosomiasis is a common helminthic infection in the tropics and subtropics, particularly in sub-Saharan African countries including Ethiopia. It imposes major health problems in areas where schistosomiasis is endemic. Neuroschistosomiasis is a rare but severe disorder caused by schistosoma and can occur at any time during schistosomal infection. The prognosis depends largely on early diagnosis and treatment.
Case reportA 30 years old male patient presented with bilateral lower extremity weakness and urinary retention (with urinary catheter in situ) of two weeks duration. He had power of 4/5, depressed reflexes and decreased sensation over the lower legs in the L4/L5distribution. Complete blood count (CBC) showed eosinophilia of 5.4%.Cerebro spinal fluid (CSF) analysis showed 50 White blood cells (WBC) with 64% lymphocytes. Magnetic resonance Image (MRI) with contrast showed distal cord and conus edema with increased T2 signal, with patchy, nodular, and linear cord surface enhancement.
ResultThe patient started on high dose prednisone 1 mg/kg and Praziquantel 40 mg/kg/day on the third day of prednisone treatment and continued for five days. The patient showed significant neurologic improvement and the catheter was removed on the seventh day of treatment.
ConclusionSpinal cord schistosomiasis should be suspected in individuals from low socioeconomic backgrounds and schistosomiasis-endemic areas who present with acute lower back pain, weakness, and urinary retention.