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[埃及血吸虫所致脊髓神经根炎:达喀尔(塞内加尔)的一例观察]

[Myeloradiculitis due to Schistosoma haematobium: about an observation in Dakar (Senegal)].

作者信息

Boubacar S, Diagne N S, Ben Adji D W, Diop A M, Seydi M, Maiga Y, Toure K, Ndiaye M, Diop A G, Ndiaye M M

机构信息

Service de neurologie, CHU Fann, 5035, Dakar, Sénégal.

Service des maladies infectieuses, CHU Fann, 5035, Dakar, Sénégal.

出版信息

Bull Soc Pathol Exot. 2016 May;109(2):77-9. doi: 10.1007/s13149-016-0479-4. Epub 2016 Mar 2.

Abstract

Nervous localisations of schistosomiasis are rare. We report the case of a 25 year-old Senegalese patient admitted for a progressive myeloradiculitis onset, over a one week period. The diagnosis of Schistosoma haematobium myeloradiculitis was made in front of a positive serum serology for S. haematobium, presence of S. haematobium eggs in urine, hyperproteinorachia, endemicity of S. haematobium in the region where the patient was originating and a past medical history of macroscopic hematuria in a context of river bathing. There was also no arguments for another cause to these neurological manifestations. Our patient was treated with praziquantel, prednisone and physiotherapy. Evolution was marked 6 weeks after the beginning of treatment by a significant improvement of motor deficit, enabling the patient to walk again. There was also a regression of genitosphincter dysfunction. Work-up for patients presenting with paraplegia in tropical countries, should also include search for S. heamatobium infection.

摘要

血吸虫病的神经定位较为罕见。我们报告一例25岁的塞内加尔患者,因在一周内逐渐出现脊髓神经根炎而入院。鉴于血清血吸虫病血清学呈阳性、尿液中存在埃及血吸虫卵、脑脊液蛋白含量增高、患者原籍地区存在埃及血吸虫流行情况以及有在河中沐浴背景下出现肉眼血尿的既往病史,诊断为埃及血吸虫脊髓神经根炎。此外,也没有证据表明这些神经表现有其他病因。我们的患者接受了吡喹酮、泼尼松和物理治疗。治疗开始6周后,病情明显好转,运动功能障碍显著改善,患者能够再次行走。泌尿生殖括约肌功能障碍也有所恢复。在热带国家,对出现截瘫的患者进行检查时,还应包括对埃及血吸虫感染的筛查。

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