Acute spinall schistosomiasis

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Abstract
A rare complication of schistosomiasis is involvement of the spinal cord which may produce a granulomatous tumor, myelitis, or cauda equina radiculitis. Two patients developing acute paraplegia during the course of a S. mansoni infection are described. These were believed to be cases of acute schistosomal myelitis. Four patients developed the signs and symptoms of radiculitis of the cauda equina: Of these, each patient, while mildly pyrexial and complaining of severe burning lumbar and sacral backache, rapidly developed a paraparesis with impairment of sphincter control. There was also sensory change to a greater or lesser degree, mainly in sacral distribution extending over the lower extremities. Reflexes were variously affected. The following findings from special investigations, although not constant, were found most useful in establishing the diagnosis: a marked eosino-philia with leucocytosis, spinal fluid pleocytosis, elevation of spinal fluid protein and normal spinal fluid glucose, and positive schistosomal complement-fixation test in the blood. The absence of evidence of urinary or bowel schistosomiasis and normal myelography does not exclude the diagnosis.

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