Parasitic infections of the spine: case series and review of the literature

Majmundar, Neil; Patel, Prachi; Dodson, Vincent; Tran, Ashley; Goldstein, Ira M.; Assina, Rachid

doi:10.3171/2018.10.focus18472

Cited by 21 publications

(26 citation statements)

References 57 publications

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“…Schistosomiasis of the central nervous system is uncommon. Spinal cord involvement in particular is a rare but well-documented presentation [4] affecting approximately 230 million people in 74 countries across Africa, Asia and America [5] of which approximately 123 million are children [1] . Schistosomiasis is second to malaria in terms of worldwide socioeconomic impact [8] .…”

Section: Discussionmentioning

confidence: 99%

Medullary neuroschistosomiasis in a pediatric patient: a case report

Kollapen

Suleman

Smuts

et al. 2022

Radiology Case Reports

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A pediatric patient with neurological deficit was examined using magnetic resonance imaging (MRI]. The images revealed abnormal signal intensity and enhancement of the spinal cord, indicating myelopathy. Identifying the cause of the myelopathy required a differential diagnosis. Images from MRI included a pre-contrast T1 weighted sagittal sequence, which revealed expansion of the distal lumbar spinal cord and conus medullaris from T10-L1. The T2 weighted sagittal sequence revealed patchy areas of hyperintense signal. We did not notice any chronic hemorrhagic products or cysts. Within the field of view, we saw multifocal areas of bladder wall thickening. Sagittal and axial T1 weighted post gadolinium images demonstrated mixed linear and nodular patchy enhancement of the conus medullaris predominantly anteriorly and along the anterior surface of the meninges. On the 18 day of hospitalization, a spinal biopsy revealed the presence of granuloma with non-viable bilharzia ova, and schistosomiasis of the spinal cord was diagnosed. Although uncommon, when it does occur, schistosomiasis has significant implications. Using MRI, the medical team noticed abnormal features that called for a biopsy, and were thus able to differentiate between medullary schistosomiasis and other infective/inflammatory conditions. A prompt diagnosis is vital for initiating early treatment, and avoiding complications and invasive surgery.

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Section: Discussionmentioning

confidence: 99%

Medullary neuroschistosomiasis in a pediatric patient: a case report

Kollapen

Suleman

Smuts

et al. 2022

Radiology Case Reports

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“…Parasitic infection of the spine is a rare condition. The most common parasites affecting the spinal canal include cysticercosis, schistosomiasis, toxoplasmosis and echinococcal disease, and are much more frequent in the developing countries of Asia and Africa [ 8 ]. The symptoms are caused by spinal cord compression or bone destruction of the vertebrae and are easy to confuse with other spine diseases such as tuberculosis, pyogenic infection, tumor or even intervertebral disc herniation.…”

Section: Discussionmentioning

confidence: 99%

“…A typical manifestation of spinal cord toxoplasmosis is vacuolar myelopathy, with intramedullary ring-enhancing lesions. The last of the most common forms of spinal parasitosis, echinococcal disease, can cause cystic lesions in the vertebral bodies, bone lysis, spondylitis or spinal cord cysts [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Parasitosis of the vertebral canal mimicking lumbar intervertebral disc herniation: a case report

Tyrakowski

Kwiatkowska

Czubak-Wrzosek

et al. 2021

BMC Musculoskelet Disord

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Study design Case report. Background It is a case of dracunculiasis of the spine mimicking lumbar intervertebral disc herniation. Case presentation A 57 year-old Caucasian male was admitted to the hospital because of the left L5 radiculopathy lasting for 2 months. The pain in the left lower limb was associated with muscle weakness on dorsal flexion of the foot, paresthesia of the dorsal aspect of the foot and tingling in the big toe. Neurological examination revealed: muscle weakness on dorsal flexion of the foot, impaired light touch and pin prick test on the dorsal aspect of the foot and positive Lasègue’s sign. Magnetic resonance imaging (MRI) examination revealed L4-L5 intervertebral disc herniation with sequester compressing the left L5 nerve root. The open L4-L5 left side discectomy was performed. During the sequester evacuation 3 pieces of nematodes were removed and preserved in 10% of formaldehyde solution. After the surgery the patient was pain free with normal neurological examination. The diagnosis of dracunculiasis was based on the morphology of the nematode and on exclusion of the other parasites. DM infestation could not be confirmed with molecular testing that was impaired by the formaldehyde. Conclusions Parasite infestation should be considered even in cases with obvious MRI of lumbar intervertebral disc herniation. If a nematode was found accidentally during any surgery it should be preserved in a 0.9% saline, not in formaldehyde, not to disturb the molecular tests.

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“…Fungal pathogens include Aspergillus and Candida species [ 1 , 13 ]. Parasitic causes include cysticercosis, schistosomiasis, toxoplasmosis, and echinococcal disease [ 1 , 14 ].…”

Section: Reviewmentioning

confidence: 99%

“…Surgery with laminectomy and decompression is the treatment of choice for spinal echinococcal disease. Needle aspiration carries a significant risk of cystic rupture and dissemination of the parasite and should be avoided [ 14 ].…”

Section: Reviewmentioning

confidence: 99%

The Diagnosis and Management of Pediatric Spine Infections

Saleh

Vasileff

Omari

et al. 2021

Cureus

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The management of pediatric spine infections requires a multidisciplinary approach that includes orthopedic surgeons, infectious disease specialists, interventional radiologists, and others. The prevalence of the disease has increased in frequency, virulence, and degree of soft tissue involvement over the past several years; there has also been a resurgence of some types of infections, such as tuberculosis, fungal, and viral pathogens. The diagnosis can often be reached with a detailed history, physical examination, laboratory tests, and imaging studies. Pathologies mimicking infection require a more invasive approach for diagnosis, including core or open biopsy. The treatment of discitis, spondylodiscitis, vertebral osteomyelitis, spinal epidural, and intramedullary abscesses in children is at times complex, and although many infections can be treated non-surgically with antibiotic therapy, some more extensive infections require surgical management. A timely diagnosis is important as it allows the initiation of the appropriate antimicrobial therapy and would decrease the complexity of the subsequent surgical intervention.

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Parasitic infections of the spine: case series and review of the literature

Cited by 21 publications

References 57 publications

Medullary neuroschistosomiasis in a pediatric patient: a case report

Medullary neuroschistosomiasis in a pediatric patient: a case report

Parasitosis of the vertebral canal mimicking lumbar intervertebral disc herniation: a case report

The Diagnosis and Management of Pediatric Spine Infections

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