Spinal cord Schistosomiasis : A child's case with an unsatisfactory outcome that mimicked an intramedullary neoplasm. A rare case report

Mohamed, Abdikarin Ahmed; Mengistu, Mihret Gebrehiwot; Haftu, Hansa; Mustefa, Mohammed; Yusuf, Abdisalam Abdullahi

doi:10.1016/j.amsu.2022.104708

Cited by 4 publications

(7 citation statements)

References 10 publications

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“…and Mohamed et al. reported a similar case in which radiologic findings of intramedullary‐enhancing lesions mimicked spinal cord tumors 6,7 . In Ahmed et al 2 .…”

Section: Discussionmentioning

confidence: 93%

“…5 Alsomaili et al and Mohamed et al reported a similar case in which radiologic findings of intramedullary-enhancing lesions mimicked spinal cord tumors. 6,7 In Ahmed et al 2 case, the radiologic findings of intramedullary-enhancing lesions mimicked transverse myelitis.…”

Section: F I G U R E 2 Site Of Laminectomy Surgerymentioning

confidence: 98%

“…2 While post-mortem studies have indicated a three to four times higher prevalence rate of asymptomatic NS cases, 5 the variability of clinical presentation and low index of suspicion can lead to misdiagnosis, even among symptomatic cases. 2,6,7 Herein, we report a case of conus intramedullary NS that mimicked transverse myelitis, and was misdiagnosed as Guillain-Barre syndrome, and subsequently led to delayed treatment and permanent neurological deficit in a 9-year-old boy.…”

Section: Introductionmentioning

confidence: 95%

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Conus medullaris neuroschistosomiasis mimicking Guillain–Barre syndrome: A case of delayed diagnosis leading to permanent neurological damage

Aljuma'ai,

Ghabisha,

Ahmed

et al. 2024

Clinical Case Reports

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Key Clinical MessageIn the evaluation of acute flaccid paralysis, particularly in pediatric populations within endemic areas for schistosomiasis infection, clinicians must maintain a high index of suspicion for neuroschistosomiasis. Prompt identification is imperative to mitigate the risk of irreversible neurological sequelae.AbstractSpinal cord involvement in neuroschistosomiasis (NS) is considerably rare, with even fewer reported cases affecting the conus medullaris in children. While NS's neurological sequelae are typically thought to be reversible, delayed diagnosis and treatment can lead to permanent deficits. We report a case of a 9‐year‐old boy who presented with 3 weeks of progressive bilateral lower extremity weakness. A spinal MRI showed patchy gadolinium enhancement in an expanded conus medullaris, leading to a presumed diagnosis of Guillain–Barre syndrome, and the patient was treated with intravenous immunoglobulin. However, the lack of improvement necessitated surgical laminectomy. The post‐operative histopathological examination confirmed the presence of a schistosomal parasite. Despite initiating therapy with corticosteroid and praziquantel, the patient did not exhibit clinical improvement, resulting in persistent flaccid paralysis, bladder, and bowel incontinence. In conclusion, spinal NS should be considered in patients presenting with myeloradicular symptoms in regions endemic for schistosomal infection, as delayed recognition can result in irreversible outcomes.

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“…and Mohamed et al. reported a similar case in which radiologic findings of intramedullary‐enhancing lesions mimicked spinal cord tumors 6,7 . In Ahmed et al 2 .…”

Section: Discussionmentioning

confidence: 93%

Section: F I G U R E 2 Site Of Laminectomy Surgerymentioning

confidence: 98%

Section: Introductionmentioning

confidence: 95%

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Conus medullaris neuroschistosomiasis mimicking Guillain–Barre syndrome: A case of delayed diagnosis leading to permanent neurological damage

Aljuma'ai,

Ghabisha,

Ahmed

et al. 2024

Clinical Case Reports

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“…On MRI, the signs of spinal schistosomiasis include the involvement of long segments, patchy enhancements, and poorly defined intramedullary lesions with cord extension 3 . Other possible findings on MRI include a mass effect, necrosis, cystic degeneration, intralesional bleeding, and perilesional oedema.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, it is crucial to consider parasite infections as a potential cause when evaluating patients with spinal cord diseases. It is believed that when mature worms become lodged in the spinal cord or brain microcirculation, they release eggs, triggering a severe granulomatous reaction that leads to the destruction and scarring of local tissue 3 .…”

Section: Introductionmentioning

confidence: 99%

Spinal schistosomiasis mimickingspinal tumour: a case report

Molla,

Alemu,

Zegeye

et al. 2024

Annals of Medicine &Amp; Surgery

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Introduction and importance: Schistosomiasis, a parasitic disease, is caused by blood flukes from the schistosoma genus. Neuroschistosomiasis is the most severe form of schistosomiasis, which occurs when the host’s brain and spinal cord react to the deposition of eggs, leading to neurological symptoms. Neuroschistosomiasis causes various signs and symptoms, such as myelopathy, radiculopathy, and elevated intracranial pressure. Case presentation: A 12-year-old child from Ethiopia who presented with progressive weakness in his lower extremities that has been ongoing for 2 months. Alongside the weakness, the patient also experienced tingling sensations and numbness in his lower extremities. Additionally, he had bladder and bowel incontinence. Spinal MRI showed signs suggestive of myxopapillary ependymoma, but the histopathology result showed schistosomiasis. Postoperatively, the patient had a slight improvement in terms of lower extremity weakness (flickering of the digits). However, there was no improvement in his continence ability. Clinical discussion: The most common neurological manifestation of Schistosoma mansoni infection is myelopathy, which includes subacute myeloradiculopathy and acute transverse myelitis. The cauda equina and conus medullaris are the areas most frequently affected. Conclusion: When spinal schistosomiasis presents itself as a mimicking spinal tumour, it poses a complex clinical challenge that necessitates a comprehensive interdisciplinary approach to ensure accurate diagnosis and effective treatment. It is imperative for healthcare practitioners to enhance their knowledge and awareness of this uncommon parasitic infection, particularly in regions where it is prevalent.

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Arborized pattern of MRI enhancement in spinal cord schistosomiasis: A report of 2 successful case outcomes

Abera,

Abdela,

Yaynishet

et al. 2024

Radiology Case Reports

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Spinal cord Schistosomiasis : A child's case with an unsatisfactory outcome that mimicked an intramedullary neoplasm. A rare case report

Cited by 4 publications

References 10 publications

Conus medullaris neuroschistosomiasis mimicking Guillain–Barre syndrome: A case of delayed diagnosis leading to permanent neurological damage

Conus medullaris neuroschistosomiasis mimicking Guillain–Barre syndrome: A case of delayed diagnosis leading to permanent neurological damage

Spinal schistosomiasis mimickingspinal tumour: a case report

Arborized pattern of MRI enhancement in spinal cord schistosomiasis: A report of 2 successful case outcomes

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