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Open Access Highly Accessed Case report

Cerebral vasculitis associated with Schistosoma mansoni infection

Guillaume Camuset1*, Valérie Wolff2, Christian Marescaux2, Ahmed Abou-Bacar3, Ermanno Candolfi3, Nicolas Lefebvre4, Daniel Christmann4 and Yves Hansmann4

Author Affiliations

1 Unité des Maladies Infectieuses, Centre Hospitalier Universitaire La Réunion, Site Sud, BP 350, 97448, Saint-Pierre, Ile de la Réunion, France

2 Département de Neurologie, Centre Hospitalier Universitaire, Strasbourg, France

3 Institut de Parasitologie, Université de Strasbourg, Strasbourg, France

4 Service des Maladies infectieuses et Tropicales, Centre Hospitalier Universitaire, Strasbourg, France

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BMC Infectious Diseases 2012, 12:220  doi:10.1186/1471-2334-12-220

Published: 14 September 2012

Abstract

Background

Cerebral involvement in schistosomiasis is not rare, but it is underdiagnosed because of the lack of clinical suspicion and the frequency of asymptomatic forms. Neurologic complications are generally supported by granuloma formation around ectopic eggs which have migrated to the brain. Moreover, vascular lesions and cerebral arteritis have been well documented in histopathological studies. Nevertheless, cerebral vasculitis in later stages of the Schistosoma mansoni infection have not yet been described in living subjects.

Case presentation

A 28-year-old french woman had a stroke linked with cerebral vasculitis, 6 monthes after returning from Burkina-Faso. At the same time, a S. mansoni disseminated infection was diagnosed. She suffered from a new stroke after undertaking praziquantel therapy, which lead us to associate the S. mansoni infection and cerebral vasculitis.

Conclusion

This is the first report of such association, since cerebral vasculitis has never been described in later stages of the S. mansoni infection. Although the causal link between the two pathologies could not be proved, we suggest that S. mansoni is able to cause severe vascular damage in cerebral vessels. Schistosomiasis must be investigated in the event of a brain infarct in young people, particularly in patients originating or returning from an endemic area.

Keywords:
Stroke; Cerebral vasculitis; Schistosoma mansoni; Corticosteroid; Praziquantel