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Medullary neuroschistosomiasis in adolescence: case report and literature review

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Medullary neuroschistosomiasis is a severe complication of gastrointestinal infection by Schistosoma. There are several endemic areas, wherein the only causative species present is Schistosoma mansoni, which is responsible for the clinical manifestations of all cases in those areas.


We report the case of a 13-year-old female with lumbar pain and progressive lower limb weakness, with a delayed diagnosis of medullary involvement by the parasite. We also reviewed the literature on the disease.


Although it is related to the less severe forms of schistosomiasis, one should pay attention to the diagnosis of neuroschistosomiasis in cases of transverse myelitis in patients who traveled to endemic areas. The delay in diagnosis and, consequently, the introduction of treatment may result in irreversible neurological sequelae.

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  1. Andrade Filho AS, Queiroz AC, Reis MG, Amaral RM, Brito RM (2015) Neuroesquistossomose. Revista Brasileira de Neurologia e Psiquiatria 19 (Ed.especial):165–209.

  2. Barnett R (2018) Schistosomiasis. The Lancet 392(10163):2431.

    Article  Google Scholar 

  3. LoVerde PT (2019) Schistosomiasis Digenetic Trematodes 45–70.

  4. Ferrari TCA, Moreira PRR (2011) Neuroschistosomiasis: clinical symptoms and pathogenesis. The Lancet Neurology 10(9):853–864.

    Article  PubMed  Google Scholar 

  5. Oliveira LS, Kuzma GSP, Costa LCV, João PRD (2020) Mielorradiculopatia esquistossomótica em região endêmica. Revista Paulista de Pediatria 38, e2018232. Epub January 13, 2020.

  6. Domingues ALC, Barbosa CS, Agit TFA, Mota AB, Frnco CMF, Lopes EP, Loyo R, Gomes ECS (2020) Spinal neuroschistosomiasis caused by Schistosoma mansoni: cases report in two brothers. BMC Infect Dis 20:724.

  7. Ferrari TCA (2004) Involvement of central nervous system in the schistosomiasis. Mem Inst Oswaldo Cruz 99(Suppl. 1):59–62.

    Article  PubMed  Google Scholar 

  8. Brito JC, Da Silva JA, Da Silva EB, Viana N (1992) Spinal cord neuroschistosomiasis: clinical and laboratory evaluation of 5 cases]. Arq Neuropsiquiatr 50(2):207–211.

    Article  CAS  PubMed  Google Scholar 

  9. Salomão JF, Duarte F, Ancilon M, De Paola F, Almeida FS (1987) Esquistossomose medular: forma tumoral. Relato de um caso Arq Neuropsiquiatria 45(3):312–323.

    Article  Google Scholar 

  10. Ferrari TCA, Moreira PR, Cunha AS (2004) Spinal cord schistosomiasis: a prospective study of 63 cases emphasizing clinical and therapeutic aspects. J Clin Neurosci 11(3):246–253.

    Article  PubMed  Google Scholar 

  11. Araújo KC, Rosa CD, Barbosa CS, Ferrari TC (2006) Clinical-epidemiological profile of children with schistosomal myeloradiculopathy attended at the Instituto Materno-Infantil de Pernambuco. Mem Inst Oswaldo Cruz. Sep;101 Suppl 1:149–56.

  12. Haribhai HC, Bhigjee AI, Bill PLA, Pammenter MD, Modi G, Hoffmann M, Becker P (1991) Spinal Cord Schistosomiasis. Brain 114(2):709–726.

    Article  PubMed  Google Scholar 

  13. Coyle CM (2013) Schistosomiasis of the nervous system. Handb Clin Neurol 114:271–281.

    Article  PubMed  Google Scholar 

  14. Tesser E, Reis MLAA, Borelli P, Matas SLA, Reis JB (2005) Cerebrospinal fluid in the diagnosis of spinal schistosomiasis. Arq Neuropsiquiatr 63(3a):661–665.

    Article  PubMed  Google Scholar 

  15. Lambertucci JR, Silva LCS, Amaral RS (2007) Guidelines for the diagnosis and treatment of schistosomal myeloradiculopathy. Rev Soc Bras Med Trop 40(5):574–581.

    Article  PubMed  Google Scholar 

  16. Pereira CU, Leão JDBC, Barreto AS, Ayala MAR, Menezes ANOA (2017) Esquistossomose medular na infância: forma tumoral. JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA 7(2), 35 - 38.

  17. Silva LCS, Maciel PE, Ribas JGR, Pereira SRS, Serufo JC, Andrade LM, Lambertucci JR (2004) Mielorradiculopatia esquistossomótica. Rev Soc Bras Med Trop 37(3):261–272.

    Article  PubMed  Google Scholar 

  18. Scaff M, Riva D, Spina-França A (1971) Meningorradiculomielopatia esquistossomótica. Arq Neuro-Psiquiatr 29(2), 227–233.

  19. Batson OV (1995) The function of the vertebral veins and their role in the spread of metastases. 1940. Clin Orthop Relat Res 312:4–9

    Google Scholar 

  20. Bloom K, Freed MM (1990) Paraplegia from schistosomiasis. Paraplegia 28(7):455–459.

    Article  CAS  PubMed  Google Scholar 

  21. Scrimgeour EM, Gajdusek DC (1985) Involvement of the Central Nervous System in Schistosoma mansoni and Schistosoma haematobium infection a review. Brain 108(4):1023–1038.

    Article  PubMed  Google Scholar 

  22. Ferrari TCA, Drumond S, Reis MG (2008) Neuroesquistossomose. In: Carvalho, OS., Coelho, PMZ., and Lenzi, HL., orgs. Schitosoma mansoni e esquistossomose: uma visão multidisciplinar [online]. Rio de Janeiro: Editora FIOCRUZ pp. 807–820. ISBN 978–85–7541- 370–8. Available from SciELO Books

  23. Pittella JE (1997) Neuroschistosomiasis. Brain pathology (Zurich, Switzerland) 7(1):649–662.

    Article  CAS  Google Scholar 

  24. Carod AFJ (2012) Cerebral and spinal schistosomiasis. Curr Neurol Neurosci Rep 12(6):666–674.

    Article  CAS  Google Scholar 

  25. Ross AG, McManus DP, Farrar J, Hunstman RJ, Gray DJ, Li Y-S (2011) Neuroschistosomiasis. J Neurol 259(1):22–32.

    Article  PubMed  Google Scholar 

  26. Ferrari TCA (2010) A laboratory test for the diagnosis of neuroschistosomiasis. Neurol Res 32(3):252–262.

    Article  PubMed  Google Scholar 

  27. Carod-Artal FJ (2010) Neuroschistosomiasis Expert review of anti-infective therapy 8(11):1307–1318.

    Article  PubMed  Google Scholar 

  28. Vidal CHF, Ferreira MLB, Azevedo Filho HRC, Gurgel FV, Brainer-Lima AM (2012) Extensive spinal cord involvement in magnetic resonance imaging evaluation on schistosomal myelitis. Arq Neuropsiquiatr 70(3):210–213.

    Article  PubMed  Google Scholar 

  29. Boyce TG (1990) Acute transverse myelitis in a 6-year-old girl with schistosomiasis. Pediatr Infect Dis J 9(4):279–284.

    Article  CAS  PubMed  Google Scholar 

  30. Moreno-Carvalho OA, Nascimento-Carvalho CM, Bacelar AL, da Silva A-F, de Souza A, Costa G, Fontes JB, Assis T (2003) Clinical and cerebrospinal fluid (CSF) profile and CSF criteria for the diagnosis of spinal cord schistosomiasis. Arq Neuropsiquiatr 61(2B):353–358.

    Article  PubMed  Google Scholar 

  31. Saleem S, Belal AI, El-Ghandour NM (2005) Spinal cord schistosomiasis: MR imaging appearance with surgical and pathologic correlation. AJNR Am J Neuroradiol 26(7):1646–1654

    PubMed  PubMed Central  Google Scholar 

  32. Carod-Artal FJ (2008) Neurological complications of Schistosoma infection. Trans R Soc Trop Med Hyg 102(2):107–116.

    Article  PubMed  Google Scholar 

  33. Suchet I, Klein C, Horwitz T, Lalla S, Doodha M (1987) Spinal cord schistosomiasis: a case report and review of the literature. Paraplegia 25(6):491–496.

    Article  CAS  PubMed  Google Scholar 

  34. Peregrino AJP, Oliveira SP, Porto CA, Santos LA, Menezes EES, Ari PB, Brito AL, Anselmo L, Pinheiro SP, Pinheiro S, Dias AB (1988) Meningomielorradiculite por Schistosoma mansoni: protocolo de investigação e registro de 21 casos. Arq Neuropsiquiatr 46(1):49–60.

    Article  CAS  PubMed  Google Scholar 

  35. Peregrino AJP, Puglia PMK, Nóbrega JPS, Livramento JA, Marques-Dias MJ, Scaff M (2002) Esquistossomose medular: análise de 80 casos. Arq Neuropsiquiatr 60(3A):603–608.

    Article  PubMed  Google Scholar 

  36. Santos EC, Campos GB, Diniz AC, Leal JC, Rocha MO (2001) Clinical profile and criteria for the diagnosis of schistosomal myeloradiculopathy. Arquivos de neuro-psiquiatria, 59(3-B), 772–777

  37. Altinyay ME, Alharthi A, Alassiri AH, Syed GM (2016) 18F-FDG Hypermetabolism in Spinal Cord Schistosomiasis. Clin Nucl Med 41(3):211–213.

    Article  PubMed  Google Scholar 

  38. Ferrari TCA, Moreira PRR, Oliveira RC, Ferrari MLA, Gazzinelli G, Cunha AS (1995) The value of an enzyme-linked immunosorbent assay for the diagnosis of schistosomiasis mansoni myeloradiculopathy. Trans R Soc Trop Med Hyg 89(5):496–500.

    Article  CAS  PubMed  Google Scholar 

  39. Lucato LT (2012) The role of magnetic resonance imaging in the management of schistosomal myeloradiculopathy. Arq Neuropsiquiatr 70(3):167–168.

    Article  PubMed  Google Scholar 

  40. de Miranda Henriques-Souza AM, & Valença MM (2011) Schistosomal Myelopathy in Childhood: Findings of Magnetic Resonance Imaging in 26 Patients. Pediatr Neurol 45(6):373–376.

    Article  PubMed  Google Scholar 

  41. Alsomaili M, Abulaban AA (2016) Spinal Cord Schistosomiasis: Two Different Outcomes Case. Rep Neurol 8 1 47 52. PMID: 27293404; PMCID: PMC4899662

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Correspondence to Patricia Alessandra Dastoli.

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Dastoli, P.A., Leite, A.L., da Costa, M.D.S. et al. Medullary neuroschistosomiasis in adolescence: case report and literature review. Childs Nerv Syst 37, 2735–2741 (2021).

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