Spinal Cord Schistosomiasis: Report on Seven Adult Patients

Background: Spinal Cord Schistosomiasis (SCS) is the most disabling ectopic form of Schistosomal infection. It may or may not have clinical manifestations. They include low back pain and/or lower limb pain and weakness, and double incontinence. Early diagnosis and treatment provide a good outcome. Aim: To describe the clinical, radiologic, and therapeutic data of 7 patients with Spinal Schistosomiasis. Patients and Methods: In this retrospective clinical case study, the medical records of 7 patients with spinal cord pathologies admitted to Aswan University Hospital from May 2014 to May 2017 were reviewed. All were male aged from 17 to 30 years old (mean ± SD, 20 ± 9.5 yr.; median 21 yr.), with neurological deficit in the form of lower limb weakness and sphincter disturbance. All were treated by decompressive laminectomy and debulking of the intramedullary lesion followed by medical treatment. Results: The outcome of our patients was good as 4/7 patients (57%) presented a full recovery, 3/7 patients (43%) presented a partial recovery without functional limitations and none presented a partial recovery with limitations or no response. Conclusion: High index of suspicion should be raised in the differential diagnosis of patients with clinical or radiological evidence of Spinal Cord Schistosomiasis, as early diagnosis can guarantee a better prognosis and avoid the occurrence of serious sequels. The association of corticosteroids and antischistosomal drugs is related to the best outcome. The role of surgery is decompression, particularly in the granulomatous or pseudotumoral form, and to obtain material for definite histopathological diagnosis in doubtful cases.