Discussion: Schistosomiasis is the second most socioeconomically devastating parasitic disease worldwide and nearly 800 million people are currently at risk of developing this parasitic infection. From the three major types, Schistosoma mansoni and Schistosoma japonicum can both cause brain involvement, but is rarely seen with S. haematobium. CNS symptoms are present only in less than 5% of patients with schistosomiasis. Neuroschistosomiasis involving the spinal cord leads to the development of myelopathy, whereas cerebral lesions often present with a wide variety of symptoms including seizures, motor and/or sensory impairment, or a cerebellar syndrome. The most definitive diagnostic findings include schistosomal eggs in the urine, stool or tissue. Serological testing is useful in non-endemic areas. Blood examination often reveals eosinophilia but this may be absent.This case showed a brain lesion that had the appearance of a glial neoplasm but additional testing including a detailed history and the presence of eosinophilia suggested the consideration of an infectious etiology. Serology and brain biopsy confirmed the definitive diagnosis with identification of the S. haematobiumova (Figure 4) with urogenital involvement. Treatment of cerebral schistosomiasis is highly effective and includes the use of praziquantel and corticosteroids.
Conclusions: Due to globalization, the geographic boundaries are getting closer and awareness of atypical presentations of common diseases that are rare in the United States is needed. Schistosomiasis should be considered in the differential diagnosis of a patient presenting with unexplained central nervous system symptoms that has either lived or even traveled to an endemic area. Treatment is effective with an overall good prognosis.
To cite this abstract:Valenzuela, M; Bromberg, D; Nanjappa, S; Greene, J . UROGENITAL SCHISTOSOMIASIS CAUSING BRAIN LESION. Abstract published at Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev. Abstract 766. Journal of Hospital Medicine. 2017; 12 (suppl 2). https://www.shmabstracts.com/abstract/urogenital-schistosomiasis-causing-brain-lesion/. Accessed September 19, 2019.