Cerebral schistosomiasis japonica without gastrointestinal system involvement.
BACKGROUND
Schistosoma japonicum is the most widespread schistosoma in the world. Although gastrointestinal system involvement with S japonicum appears to be considerably common, cerebral schistosomiasis is not frequent. Cerebral schistosomiasis japonica intestinal and hepatosplenic involvement is more rare. We collected 2 cases of cerebral schistosomiasis identified by pathological diagnosis, lacking extracranial involvement. In addition, one of them had multiple lesions, which was also rare.


METHODS
Two male patients came from Dongting Lake region, Hunan province, one of the oldest and most severe endemic areas of China. Their clinical symptoms varied, such as headache, dizziness, seizures, and others. Studies in blood were normal except for eosinophilia. Computed tomography of brains showed hyperdense areas, and MRI showed isointense signal on T1-weighted images, hyperintense signal on T2-weighted images, and heterogeneous enhancement. The definitive diagnosis was cerebral schistosomiasis japonium by biopsy. Standard use of praziquantel and corticosteroid drugs was applied, and the prognosis was good.


CONCLUSIONS
Cerebral schistosomiasis japonica without intestinal and hepatosplenic involvement is exactly rare and easily ignored. The diagnosis sometimes is difficult. Laboratory and imaging examinations are helpful but not specific. Although operation can give the definitive diagnosis, it is not imperative. The administration of praziquantel and corticosteroid drugs in early stages is good for prognosis.
Zhou
Jinxia
J
Department of Neurology at Xiangya Hospital, Central South University, Changsha, Hunan 410008, China.
Li
Guoliang
G
Xia
Jian
J
Xiao
Bo
B
Bi
Fangfang
F
Liu
Ding
D
Chen
Chanjuan
C
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000871:Anthelmintics / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001921:Brain / Q000000981:diagnostic imaging / Q000469:parasitology* / Q000473:pathology; D001929:Brain Edema / Q000000981:diagnostic imaging / Q000469:parasitology / Q000473:pathology; D003937:Diagnosis, Differential; D041981:Gastrointestinal Tract / Q000469:parasitology / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D020818:Neuroschistosomiasis / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology*; D011223:Praziquantel / Q000627:therapeutic use; D011237:Predictive Value of Tests; D012554:Schistosomiasis japonica / Q000175:diagnosis* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000871:Anthelmintics; D000893:Anti-Inflammatory Agents; D011223:Praziquantel