Diagnosis of neuroschistosomiasis by antibody specificity index and semi-quantitative real-time PCR from cerebrospinal fluid and serum.
We describe the case of a 16-year-old German male expatriate from Ghana who presented with obstipation, dysuria, dysaesthesia of the gluteal region and the lower limbs, bilateral plantar hypaesthesia and paraesthesia without pareses. A serum-cerebrospinal fluid (CSF) Schistosoma spp. specific antibody specificity index of 3.1 was considered highly suggestive of intrathecal synthesis of anti-Schistosoma spp. specific antibodies, although standardization of this procedure has not previously been described. Diagnosis was confirmed by detection of Schistosoma DNA in CSF by semi-quantitative real-time PCR at 100-fold concentration compared with serum. Accordingly the two diagnostic procedures, which have not previously been applied for routine diagnosis, appear to be useful for the diagnosis of neuroschistosomiasis. Clinical symptoms resolved following anthelmintic and anti-inflammatory therapy.
Department of Infectious Diseases and Clinical Immunology, Comprehensive Infectious Diseases Centre Ulm and Clinic of Internal Medicine III, University Hospital Ulm, Germany.
Georg
G
Härter
Institute for Microbiology, Virology and Hygiene, University Hospital Rostock, Germany.|Department of Tropical Medicine at the Bernhard Nocht Institute, German Armed Forces Hospital of Hamburg, Germany.
Hagen
H
Frickmann
Institute for Medical Microbiology and Hygiene, University Hospital Ulm, Germany.
Sebastian
S
Zenk
Department of Intensive Care Medicine, University Hospital Eppendorf, Hamburg, Germany.
Dominic
D
Wichmann
Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Germany.
Bettina
B
Ammann
Department of Infectious Diseases and Clinical Immunology, Comprehensive Infectious Diseases Centre Ulm and Clinic of Internal Medicine III, University Hospital Ulm, Germany.
Peter
P
Kern
Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
Bernhard
B
Fleischer
Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
Egbert
E
Tannich
Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
Sven
S
Poppert
D000293:Adolescent; D000818:Animals; D000909:Antibodies, Helminth / Q000097:blood* / Q000134:cerebrospinal fluid*; D000918:Antibody Specificity; D018509:DNA, Helminth / Q000134:cerebrospinal fluid; D054242:Emigrants and Immigrants; D005858:Germany; D005869:Ghana; D006801:Humans; D008297:Male; D020818:Neuroschistosomiasis / Q000175:diagnosis* / Q000469:parasitology / Q000473:pathology; D060888:Real-Time Polymerase Chain Reaction; D012547:Schistosoma / Q000235:genetics* / Q000276:immunology*
D000909:Antibodies, Helminth; D018509:DNA, Helminth