Olson S, Rossato R, Guazzo E
Townsville General Hospital, Eyre Street, North Ward, Townsville, Queensland, 4810, Australia.
J Clin Neurosci. 2002 May;9(3):317-20. doi: 10.1054/jocn.2001.0981.
A 23 year old female presented to Townsville General Hospital seven months after a positive urine test for Schistosomiasis with conus modularize signs. MRI confirmed a conus medullaris enhancing lesion. Serology was positive for Schistosoma IgG : IgM, 3.4 : 1.8. Urine screening for ova, stool sample, rectal biopsy and diagnostic investigations were negative. She was treated empirically for Schistosoma without biopsy with marked resolution of her symptoms and signs. She remains neurologically well one year after presentation. Serological identification from the Centre of Disease Control and Prevention in Atlanta Georgia by western blot has shown positive IgG for Schistosoma haematobium and mansoni. Schistosoma myelopathy is a rare cause of transverse myelitis, conus medullaris syndrome, anterior spinal artery occlusion and radiculopathy in Australia. It should however be included in the differential diagnosis in a patient who has been in or presenting from an endemic area.
一名23岁女性在尿液血吸虫病检测呈阳性7个月后，因圆锥综合征体征就诊于汤斯维尔综合医院。磁共振成像（MRI）证实圆锥髓质有强化病变。血吸虫病IgG:IgM血清学检测结果为阳性，比值为3.4:1.8。尿液虫卵筛查、粪便样本、直肠活检及诊断性检查均为阴性。她未经活检接受了血吸虫病经验性治疗，症状和体征明显缓解。就诊一年后，她的神经系统状况良好。美国佐治亚州亚特兰大疾病控制与预防中心通过免疫印迹法进行的血清学鉴定显示，埃及血吸虫和曼氏血吸虫的IgG呈阳性。在澳大利亚，血吸虫性脊髓病是横贯性脊髓炎、圆锥综合征、脊髓前动脉闭塞和神经根病的罕见病因。然而，对于来自或曾去过流行地区的患者，应将其纳入鉴别诊断范围。
