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The worm that turned.

C A Macdonald1, D L Jardine, M A Hurrell

  • 1Department of General Medicine, Christchurch Hospital, Private Bag 4710, Christchurch, New Zealand. christy80@clear.net.nz

Transactions of the Royal Society of Tropical Medicine and Hygiene
|June 23, 2009
PubMed
Summary
This summary is machine-generated.

Helminthic infections like Schistosoma mansoni can cause acute myelopathy, even years after exposure. Early diagnosis and treatment with praziquantel and methylprednisolone are crucial for recovery.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Parasitology

Background:

  • Acute myelopathy is typically investigated for common causes in developed countries, often overlooking parasitic infections.
  • Helminthic infections are rarely considered in the differential diagnosis of acute myelopathy in non-endemic regions.

Observation:

  • A 34-year-old South African male presented with acute urinary retention and lower leg paresthesia.
  • Magnetic resonance imaging revealed characteristic changes in the conus medullaris, and stool microscopy confirmed Schistosoma mansoni infection.

Findings:

  • The patient was diagnosed with myeloradiculopathy secondary to Schistosoma mansoni despite no recent exposure to infected water for 22 years.
  • Symptoms resolved completely following treatment with praziquantel and methylprednisolone.

Implications:

  • Spinal schistosomiasis is a rare but significant cause of myelopathy that warrants consideration in patients with a history of living in or visiting endemic areas.
  • This case highlights the importance of a broad differential diagnosis for myelopathy, including neglected tropical diseases.