Cerebral schistosomiasis caused by Schistosoma mansoni: a case report with clinical analysis

ABSTRACT

Central nervous system involvement arising from schistosomiasis is uncommon. It may be produced most frequently by Schistosoma japonicum infection, but reports of S. mansoni presenting as an intracerebral mass lesion are particularly rare. The authors describe the case of a 35-year-old woman with a 3-month history of partial epileptic seizures and headaches. She immigrated to Egypt 4 years ago and had worked in Iraq for 2 years after the immigration. The patient's general physical and neurological examinations were unremarkable. Magnetic resonance [MR] imaging revealed an enhancing lesion with surrounding edema and mild mass effect in the left frontal lobe. A stereotactic brain biopsy demonstrated intraparenchymal granulomas surrounding S. mansoni eggs. S. mansoni was identified by stool examination. Prednisone [1 mg/kg per day for 1 week, with gradual withdrawal during the following 3 weeks] and praziquantel [2 doses at 20 mg/kg per day] therapy was initiated. The patient's symptoms resolved following medical treatment and the follow-up MR imaging yielded normal findings. This case is the rare imported case of cerebral schistosomiasis in China and the neuroschistosomiasis should be considered as the patient lived in a region in which this disease is endemic