Silvestri Valeria, Mushi Vivian, Ngasala Billy, Kihwele Jacqueline, Sabas Deodatus, Rocchi Lorenzo
Department of Parasitology and Medical Entomology, Muhimbili University of Health and Applied Science, P.O. Box 65011, Dar es Salaam, Tanzania.
Department of Internal Medicine, Muhimbili University of Health and Applied Science, P.O. Box 65001, Dar es Salaam, Tanzania.
Can J Infect Dis Med Microbiol. 2022 Jul 25;2022:3902570. doi: 10.1155/2022/3902570. eCollection 2022.
Cerebral vascular comorbidities may occur in patients with schistosomiasis, as described in case reports. We have summarized general clinical and neurological features in patients with stroke associated with schistosomiasis, through a review of case reports in the literature. A total of eight case reports were retrieved. The mean age of patients was 36.42 ± 16.7 (19 to 56 years), four females, three males, and one anonymous sex. Eosinophilia was the most frequent feature at presentation, followed by cardiac abnormalities, confusion, fever, ataxia, hemiplegia, headache, urticaria, dysphasia, and memory impairment. Patients usually present with watershed infarction or intracranial vasculitis. In one case, extracranial carotid arteries presented with inflammation and stenosis. The patient's serology was positive on admission in five cases. Full neurological recovery was reported in three cases, and partial improvement in another three. In two cases, information on neurological outcomes was incomplete. Stroke in schistosomiasis can be caused by haemodynamic impairment, direct lesion to the arterial wall, vasa vasorum obliterative endarteritis, contiguity with a focus of inflamed tissue, or inflammatory intimal damage. Schistosomiasis needs to be included in the differential diagnosis of stroke in people living or coming back from endemic areas.
Further studies addressing the noncommunicable comorbidity issues related to this condition are needed.
如病例报告所述，血吸虫病患者可能会出现脑血管合并症。我们通过回顾文献中的病例报告，总结了血吸虫病相关性卒中患者的一般临床和神经学特征。共检索到8篇病例报告。患者的平均年龄为36.42±16.7岁（19至56岁），女性4例，男性3例，1例性别未提及。嗜酸性粒细胞增多是最常见的表现特征，其次是心脏异常、意识模糊、发热、共济失调、偏瘫、头痛、荨麻疹、言语困难和记忆障碍。患者通常表现为分水岭梗死或颅内血管炎。1例患者的颅外颈动脉出现炎症和狭窄。5例患者入院时血清学呈阳性。3例患者报告神经功能完全恢复，另3例部分改善。2例患者的神经学转归信息不完整。血吸虫病相关性卒中可能由血流动力学损害、动脉壁直接损伤、滋养血管闭塞性动脉内膜炎、与炎症组织病灶相邻或炎症性内膜损伤引起。对于生活在疫区或从疫区返回的人群，在卒中的鉴别诊断中需要考虑血吸虫病。
需要进一步研究解决与这种疾病相关的非传染性合并症问题。
