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Vol. 12. Issue 2.
Pages 160-164 (January 2001)
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Vol. 12. Issue 2.
Pages 160-164 (January 2001)
Esquistosomiasis medular. Presentación de un caso clínico
Schistosomiasis of the spinal cord. Case report
M. Soto, A. Bollar, E. Astudillo
Servicio de Neurocirugía. Hospital de Aranzazu. Complejo Hospitalario Donostia. San Sebastián
B. Indacoechea*, C. Lobo**
* Servicio de Neurología. Hospital de Aranzazu. Complejo Hospitalario Donostia. San Sebastián
** Servicio de Anatomía Patológica. Hospital de Aranzazu. Complejo Hospitalario Donostia. San Sebastián
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Resumen

Se presenta la observación clínica de una paciente de 34 años que, después de haber realizado en los últimos cuatro años diversos viajes a África, desarrolla un cuadro progresivo de afectación de cono medular, de tres meses de evolución, en el que predominan los trastornos sensitivos.

Ante las imágenes de la Resonancia Magnética (RM), que mostró una lesión intramedular, y la negatividad de las pruebas específicas efectuadas, se procedió a la verificación histológica que correspondió a una granulomatosis por huevos de Esquistosoma Hematobium. Una vez establecido el diagnóstico correcto se inició tratamiento médico con praziquantel.

Se resalta la relativa frecuencia de la localización medular de la esquistosomiasis en aquellos países en los que es endémica, y la utilidad del diagnóstico de laboratorio que permite iniciar de una forma precoz el tratamiento médico. A pesar de su rareza es conveniente sospechar y reconocer esta posibilidad nosológica entre las diferentes causas de afectación medular progresiva.

Palabras clave:
Esquistosomiasis
Neurohelmintiasis
Mielopatía
Summary

The authors report a case of a 34 year-old woman who, in the last four years, had travelled to África frequently, and developed a progressive clinical (about three months) dysfunction of the conus medullaris mainly consisting in sensitive disturbances.

The MRI showed an intramedullary spinal cord lesion, and specificic laboratory tests were negative. A biopsy for histologic diagnosis, showed a granulomatous tissue with eggs of S. Hematobium. After this diagnosis she was treated with praziquantel.

We emphasize the relative frecuency of the spinal cord location of schistosomiasis in endemic countries, and the importance of the laboratory diagnosis to start an early and effective antischistosomal treatment. Spinal cord schistosomiasis is uncommon but we must bear in mind this posibility in patients with a progressive spinal cord afectation.

Key words:
Schistosomiasis
Neurohelminthasis
Myelopathy

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