Stroke in Patients with Schistosomiasis: Review of Cases in Literature

Table 1

Summary of case reports included in review.

Case number	Author	Age	Sex	Schistosomiasis details	Clinical presentation	Cerebrovascular involvement	Cardiac abnormalities	Schistosomiasis diagnosis	Additional events	Outcome
1	Sarazin 2004	25	F	Madagascar (3 months journey)	Day 0 = abdominal pain, diarrhea, myalgia. 1 week fever 38°C, rapidly progressive headache, limb ataxia, loss of memory	Bilateral watershed infarcts	Non-calcific endomiocardial fibrosis	Initial serology, stool and urine investigations negative. Stool positive and seroconversion after 3 weeks	Progression of cardiomyopathy in 16 months	No neurological recurrence
2	Sonneville 2006	56	F	n.a.	Day 0 = hemiplegia. History of recent progressive dyspnoea	Multiple watershed infarcts	Acute pericarditis and myocarditis	Positive serology	None	Neurological recovery at 6 month
3	Jaureguiberry 2007 pt 1	54	M	Lived in Mali for several years. Repeated exposure to fresh ground water	Day 0 = cerebellar syndrome and hemiparesis, confusion. 10 day history of fever 40°C	Multiple, bilateral cortical infarcts	ST tract inversion	Serology positive at 4 months	None	Psychomotor slowing and insomnia at 4 months
4	Jaureguiberry 2007 pt 2	21	M	Bathed in a lake in Mali 1 month before onset (maculopapular rash)	Day 0 = myalgia, headache, fever 39°C. Day 2 = started praziquantel. Day 4 = mental confusion, anosognosia	Cerebral vasculitis	Inverted T waves, high troponin	Positive serology, negative stool and urine	None	Full recovery in 48 h after steroid therapy
5	Camuset 2012	28	F	Burkina faso (mission-1 year), reported swimming in lake	Headache for 6 months Day 0 = transient hemiplegia, language disorders day1 = persistent hemiplegia	Watershed infarcts, carotid artery inflammation and stenosis	n.a	Positive serology, negative stool and urine, positive rectal biopsy	Development of VI cranial nerve palsy due to inflammation of carotid syphon, likely caused by praziquantel, 1 month after the first clinical observation	Minor improvement of carotid stenosis at 6 months
6	Wu 2012	n.a.	n.a.	n.a.	Acute headache, walking impairment	Multiple frontal lobes infarcts	None	n.a	n.a.	n.a.
7	Grandiere Peréz 2013	19	M	Bathed in Lake Victoria (Kenya) for 3 months	Day 0 = 15 days fever 39°C,weight loss, urticaria. Inverted T wave and positive troponin day 8 = recovery day 12 = ataxia, confusion, unilateral dysmetria	Watershed infarct	Myocarditis	Positive serology, negative stool and urine, then positive after 4 months	None	Full neurological recovery after a five-day steroid course
8	Nyein 2020	52	F	Visited hometown 1 year previously during schistosomiasis outbreak in Myanmar, ate snails, swam in pond	Day 0 = cognitive impairment, memory deficit, behavioral changes week 3 = dysarthria, hemiplegia, upper motor neuron facial palsy	Multiple cerebral infarcts, carotid and anterior cerebral arteries narrowing	None	Positive serology, negative stool + ova	New cerebral lesions after 3 and 9 weeks	Walked with aid at 6 months

“Day 0” refers to the first clinical evaluation. N.a: information not available.