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Meningomyeloradiculitis by Schistosoma mansoni: investigation protocol and report of 21 cases

Twenty one cases of schistosomal meningomyeloradiculopathy due to Schistosoma mansoni are reported. This result was attained after a 4 years research period based on a «Clinical and Laboratory Investigation Protocol» applied on 212 patients in Itabuna, a city of Southeast region of Bahia state in the Northeast of Brazil. This region is a non endemic one for schistosomiasis. The Protocol consisted in leading to investigation every pacient that presented a clinical triad characterized by: lumbar pain, paresthesias in the inferior limbs, miction difficulties. Diagnostic criteria were based on clinical neurologic signs, presence of Schistosoma mansoni eggs on feces or rectum biopsy, positive immunofluorescence reaction for schistosomiasis in the cerebrospinal fluid (CSF), the inflammatory CSF characteristics, and an exhaustive research for differencial diagnosis. The diagnosis has been essentially based on clinical and laboratory data, not having for any of the cases an histopathological study. The treatment was performed the earliest as possible, and corticosteroids associated to oxaminiquine were used for all cases. The pacients were, studied as to sex, age, profession, city of origin, initial symptoms, laboratory tests related to schistosomiasis, the onset type of neurologic clinical symptoms and several CSF aspects.


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