Volume 86, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



The authors report three rare cases of neuroschistosomiasis lacking extracranial involvement. No parasitic eggs were detected in the stool with the Kato–Katz thick smear methods. Computed tomography of the brains showed hypodense signals, and magnetic resonance imaging showed isointense signals on T1-weighted images, hyperintense signals on T2-weighted images, and intensely enhancing nodules in the brain after intravenous administration of gadolinium. High-grade gliomas were suspected, and operations or radiosurgery was performed. Cerebral schistosomiasis was confirmed in all cases by biopsy of the brain lesions, revealing granulomas containing embedded eggs. All cases were definitively diagnosed as brain schistosomiasis japonica. Praziquantel and corticosteroids were administered, and the prognoses were good for all case patients. Although the aforementioned pattern of imaging examinations is not present in all cases of neuroschistosomiasis, a diagnosis of neuroschistosomiasis should be considered when this pattern of imaging is observed; cerebrospinal fluid serological exams are also recommended.


Article metrics loading...

Loading full text...

Full text loading...



  1. Mao SP, Shao BR, , 1982. Schistosomiasis control in the People's Republic of China. Am J Trop Med Hyg 31: 9299.
  2. Zhou D, Li YS, Yang W, , 1994. Schistosomiasis control in China. World Health Forum 15: 387389.
  3. Hayashi M, , 2003. Clinical features of cerebral schistosomiasis, especially in cerebral and hepatosplenomegalic type. Parasitol Int 52: 375383.[Crossref]
  4. Carod-Artal FJ, , 2008. Neurological complications of Schistosoma infection. Trans R Soc Trop Med Hyg 102: 107116.[Crossref]
  5. Zhou H, Ross AG, Hartel GF, Sleigh AC, Williams GM, McManus DP, Luo XS, He Y, Li YS, , 1998. Diagnosis of schistosomiasis japonica in Chinese schoolchildren by administration of a questionnaire. Trans R Soc Trop Med Hyg 92: 245250.[Crossref]
  6. Ross AG, Sleigh AC, Li Y, Davis GM, Williams GM, Jiang Z, Feng Z, McManus DP, , 2001. Schistosomiasis in the People's Republic of China: prospects and challenges for the 21st century. Clin Microbiol Rev 14: 270295.[Crossref]
  7. Wan H, Masataka H, Lei T, Liang W, Li M, , 2009. Cerebral schistosomiasis caused by Schistosoma mansoni: a case report with clinical analysis. Iran J Parasitol 4: 6166.
  8. Wan H, Lei D, Mao Q, , 2009. Cerebellar schistosomiasis: a case report with clinical analysis. Korean J Parasitol 47: 5356.[Crossref]
  9. Lee YK, Choit Y, Jin SY, Lee DW, , 1995. Imported CNS schistosomiasis – a case report. J Korean Med Sci 10: 5761.[Crossref]
  10. Shu K, Zhang S, Han L, Lei T, , 2009. Surgical treatment of cerebellar schistosomiasis. Neurosurgery 64: 941943.[Crossref]
  11. Jaureguiberry S, Ansart S, Perez L, Danis M, Bricaire F, Caumes E, , 2007. Acute neuroschistosomiasis: two cases associated with cerebral vasculitis. Am J Trop Med Hyg 76: 964-966.
  12. George J, Rose D, Hazrati LN, Majl L, Hodaie M, , 2009. Cerebral schistosomiasis–an unusual presentation of an intracranial mass lesion. Can J Neurol Sci 36: 244247.[Crossref]
  13. Schils J, Hermanus N, Flament DJ, Van GD, Baleriaux D, , 1985. Cerebral schistosomiasis. AJNR Am J Neuroradiol 6: 840841.
  14. Nascimento CM, Moreno OA, , 2004. Clinical and cerebrospinal fluid findings in patients less than 20 years old with a presumptive diagnosis of neuroschistosomiasis. J Trop Pediatr 50: 98100.[Crossref]
  15. Lambertucci JR, , 1993. Acute schistosomiasis: clinical diagnostic and therapeutic features. Rev Inst Med Trop Sao Paulo 35: 399404.[Crossref]
  16. Ariizumi M, , 1963. Cereberal Schistosomiasis japonica: report of one operated case and fifty clinical cases. Am J Trop Med Hyg 12: 4045.
  17. Yu JM, de Vlas SJ, Jiang QW, Gryseels B, , 2007. Comparison of the Kato-Katz technique, hatching test and indirect hemagglutination assay (IHA) for the diagnosis of Schistosoma japonicum infection in China. Parasitol Int 56: 4549.[Crossref]
  18. Liu LX, , 1993. Spinal and cerebral schistosomiasis. Semin Neurol 13: 189200.[Crossref]
  19. Carod-Artal FJ, , 2007. Neurological complications of Schistosoma infection. Trans R Soc Trop Med Hyg 102: 107116.[Crossref]
  20. Richter J, Hatz C, Haussinger D, , 2003. Ultrasound in tropical and parasitic diseases. Lancet 362: 900902.[Crossref]
  21. Wan H, Masataka H, Lei T, Li M, , 2009. Magnetic resonance imaging and cerebrospinal fluid immunoassay in the diagnosis of cerebral schistosomiasis: experience in southwest China. Trans R Soc Trop Med Hyg 103: 10591061.[Crossref]
  22. Hou XY, McManus DP, Gray DJ, Balen J, Luo XS, He YK, Ellis M, Williams GM, Li YS, , 2008. A randomized, double-blind, placebo-controlled trial of safety and efficacy of combined praziquantel and artemether treatment for acute schistosomiasis japonica in China. Bull World Health Organ 86 788795.[Crossref]
  23. Zhu H, Yu C, Xia X, Dong G, Tang J, Fang L, Du Y, , 2010. Assessing the diagnostic accuracy of immunodiagnostic techniques in the diagnosis of schistosomiasis japonica: a meta-analysis. Parasitol Res 107: 10671073.[Crossref]
  24. Zhou YB, Yang MX, Tao P, Jiang QL, Zhao GM, Wei JG, Jiang QW, , 2008. A longitudinal study of comparison of the Kato–Katz technique and indirect hemagglutination assay (IHA) for the detection of schistosomiasis japonica in China, 2001–2006. Acta Trop 107: 251254.[Crossref]
  25. Devine MJ, Wilkinson PA, Doherty JF, Jarman PR, , 2008. Neuroschistosomiasis presenting as brainstem encephalitis. Neurology 70: 22622264.[Crossref]
  26. Preidler KW, Riepl T, Szolar D, Ranner G, , 1996. Cerebral schistosomiasis: MR and CT appearance. AJNR Am J Neuroradiol 17: 15981600.
  27. Mehta A, Teoh SK, Schaefer PW, Chew FS, , 1997. Cerebral schistosomiasis. AJR Am J Roentgenol 168: 1322.[Crossref]
  28. Mackenzie IR, Guha A, , 1998. Manson's schistosomiasis presenting as a brain tumor. Case report. J Neurosurg 89: 10521054.[Crossref]
  29. Ching HT, Clark AE, Hendrix VJ, Kobrine AI, Schwartz AM, , 1994. MR imaging appearance of intracerebral schistosomiasis. AJR Am J Roentgenol 162: 693694.[Crossref]
  30. Fowler R, Lee C, Keystone JS, , 1999. The role of corticosteroids in the treatment of cerebral schistosomiasis caused by Schistosoma mansoni: case report and discussion. Am J Trop Med Hyg 61: 4750.
  31. Carod-Artal FJ, , 2010. Neuroschistosomiasis. Expert Rev Anti Infect Ther 8: 13071318.
  32. Matsuda M, Fujii H, , 2009. Chronic schistosomiasis japonica is an independent adverse prognostic factor for survival in hepatocellular carcinoma patients who have undergone hepatic resection: clinicopathological and prognostic analysis of 198 consecutive patients. World J Surg 33: 26442650.[Crossref]
  33. Richards F, Sullivan J, Ruiz TE, , 1989. Effect of praziquantel on the eggs of Schistosoma mansoni with a note on the implications for managing central nervous system schistosomiasis. Ann Trop Med Parasitol 83: 465472.[Crossref]
  34. Watt G, Adapon B, Long GW, , 1986. Praziquantel in treatment of cerebral schistosomiasis. Lancet 2: 529532.[Crossref]

Data & Media loading...

  • Received : 05 Aug 2011
  • Accepted : 04 Nov 2011

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error