Naus C W A, Chipwete J, Visser L G, Zijlstra E E, van Lieshout L
Department of Parasitology, Centre for Infectious Diseases, Leids Universitair Medisch Centrum, L4-Q, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
Ann Trop Med Parasitol. 2003 Oct;97(7):711-21. doi: 10.1179/000349803225002363.
In Malawi, although schistosomal myelopathy has been reported in visitors from overseas who have swum in Lake Malawi, the incidence of this disorder in local residents has never been investigated. Consecutive patients with non-traumatic disorders of the spinal cord were therefore recruited in a hospital and a rehabilitation centre in Blantyre. Of the 33 patients investigated, 16 were presumed to be cases of schistosomal myelopathy as they had the markers of past or current schistosomiasis and apparently no other conditions that could explain their clinical features. There was microscopical and/or immunodiagnostic evidence indicating that eight of these presumptive cases had active schistosomiasis. All 16 presumptive cases had symptoms that were similar to those of 177 presumptive or proven cases of neuroschistosomiasis described in the scientific literature. Following antihelminthic treatment, eight of the presumptive cases showed marked improvement. Schistosomal myelopathy seems to occur relatively frequently in Malawi. Early treatment with praziquantel is strongly recommended for all patients with unexplained myelopathy and a history of exposure to schistosome cercariae.
在马拉维，尽管有报道称来自海外的游客在马拉维湖游泳后患上了血吸虫性脊髓病，但当地居民中这种疾病的发病率从未得到过调查。因此，在布兰太尔的一家医院和一家康复中心招募了患有非创伤性脊髓疾病的连续患者。在接受调查的33名患者中，有16名被推测为血吸虫性脊髓病病例，因为他们有过去或当前血吸虫病的标志物，且显然没有其他能够解释其临床特征的病症。有显微镜检查和/或免疫诊断证据表明，这些推定病例中有8例患有活动性血吸虫病。所有16例推定病例的症状与科学文献中描述的177例推定或确诊的神经血吸虫病病例相似。经过抗蠕虫治疗后，8例推定病例有明显改善。血吸虫性脊髓病在马拉维似乎相对常见。强烈建议对所有患有无法解释的脊髓病且有接触血吸虫尾蚴病史的患者尽早使用吡喹酮进行治疗。
