Neuroschistosomiasis mimicking lower back pain: case report of a rare differential diagnosis in a pediatric patient

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Neuroschistosomiasis mimicking lower back pain: case report of a rare differential diagnosis in a pediatric patient


JournalPatient Safety in Surgery
Publication date – Oct – 2018
Authors – Abdulrahman Hamad Al-Abdulwahhab, Abdulaziz Mohammad Al-Sharydah, Sari Saleh Al-Suhibani, Saeed Ahmad Al-Jubran, Ali Khalaf Al-Haidey, Abdulkhaliq Ibrahim Al-Hifzi and Wissam Al-Issawi
KeywordsConus medullaris Magnetic resonance imaging Myelitis Neuroschistosomiasis
Open access – Yes
SpecialityNeurosurgery, Paediatric surgery, Trauma and orthopaedic surgery
World region Western Asia
Country: Saudi Arabia
Language – English
Submitted to the One Surgery Index on November 3, 2018 at 9:02 pm
Abstract:

Background
Spinal myelitis is an infrequent manifestation of spinal cord infection. It is caused by the Schistosoma species, which are endemic in South America, part of the Middle East, and Africa.

Case presentation
We report the case of a 13-year-old male adolescent complaining of progressive lower back pain and weakness of the lower extremities for 3 days. Initial magnetic resonance imaging revealed typical transverse myelitis. Subsequently, parasite serology showed a markedly elevated level of Schistosoma antibody titers, and cerebrospinal fluid analysis yielded normal results. Because of our presumptive diagnosis of neuroschistosomiasis, the patient was prescribed an empirical regimen of an anti-parasitic agent, after which his neurological deficit promptly subsided. The patient was followed for 1 year and showed a complete long-term resolution of symptoms.

Conclusions
This case highlights the increasing prevalence of neuroschistosomiasis in recent years, particularly in patients with a history of travel to endemic regions. Moreover, the study reports the clinicoradiological features of this enigmatic disorder. This rare occurrence potentiates further studies to address unanswered questions about neuroschistosomiasis.

OSI Number – 20280
PMID – 30323860

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