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Occurrence of Schistosoma mattheei-like eggs in a spinal cord lesion
230
TRANSACTIONS OF THE ROYALSOCIETYOF TROPICALMEDICINEAND HYGIENE(1991)85, 230
Occurrence mattheei-like lesion
of Schistosoma eggs in a spinal
cord
P. J. Fripp and J. Joubert
Departments of MicrobiologylParasitologv and Neurology, Medical University of Southern Africa, P.O. Medunsa 0204, Republic of South Africa
Schistosomiasis of the spinal cord may be a more common condition than is realised at Ga-Rankuwa Hospital situated 30 km north-west of Pretoria in the Transvaal province of South Africa. During the last 6 years, several casesof myelopathy of unknown origin have been seenin which the only relevant finding was positive schistosomiasisserology and where the condition subsequently responded to treatment with praziquantel (Biltricide@). Over a period of 3 years, 5 cases presented each with a lesion of the spinal cord and with positive cercarial fluorescent antibody serology. In 3 of these cases, surgery was performed and the routine histology reports noted granulomata containing unspecified schistosome eggsat different stagesof disintegration. There was no reference to the presence of adult flukes in the lesions. The histological sections were later reviewed. In one 9 years old female, in addition to both live and dead Schistosoma haematobium eggs, an occasional terminal-spined egg with pronounced ‘shoulders’ resembling S. mattheei was seen (Figure). At the time of the initial diagnosis, routine stool analysis had revealed schistosomeeggs which were identified as S. mattsoni; but no S. mat&xi eggs were reported, and eggs of S. haematobium had been found in the urine.
The patient was given a course of praziquantel and made a complete recovery. The patient came from Venda, a region adjacent to the northcru Transvaal, where S. mattheei is primari!! a oarasite of domestic and wild vertebrates. However, eggs may often be found in the faeces of children, notahlv herd-bovs. and in some areasof South Africa the prevalence $‘the human population may reach 40% (PITCHFORD, 1961). It probably does not occur as a pure infection in humans but only coexists with S. haematobium, when some degree of hybridization between S. haematobium males and S. mattheei females takes place (PITCHFORD, 1961, 1965; KRUGER, 1986; KRUGER et al., 1990). Table. Schistosoma haematobium and S. matieei: parison of egg lengths (in micrometers)
Free 83-187” S. haematobium 146259” s. fnattheei S. haematobium x S. mattheei 169 (sd=13) “From
PITCHFORD,
com-
Fixed 105-126b 147b
1965.
bThis paper. ‘From KRUGER et al., 1986; sd=standarddeviation. PITCHFORD (1965) showed that free ‘S. matthei’ (or S. haematobium x S. mattheei hybrid) eggs isolated
from human urine and faeces were larger than S. haematobium eggs in urine. Measurements of 9 eggs assumedto be c;t sagittally in the sections of the c&d lesion gave a mean length of 116 pm (105-126 pm). The length of the putative S. mattheei egg shown in the Figure, derived from measurementsin 2 adjacent sections, was 147 e, longer than the clearly identifiable S. haematobium eggs but shorter than free S. mattheei eggs (Table). If the ‘shoulders’ were fixation or sectioning artifacts, its length would be expected to be shorter than that of undistorted S. haematobium eggs. This seems to be the first record of the occurrence of S. mattheei or S. haematobium x S. mattheei hybrid eggs in a human spinal cord lesion. References
Gear, J. H. S,., Pitchford, R. J. & van Eeden, J. A. (l?SO). Atlas of Btlharzia. Johannesburg: South African Insutute for Medical Research. Kruger, F. J., Schutte, C. H. J., Visser, P. S. & Evans, A. C. (1986). Phenotypic differences in Schistosumo matthai ova from populations sympatric and allopatric to S. haematobium. Onderstepwrt Jouwtal of Veterkaty Research, 53, 10>107. Kruger, F. J., Joubert, P. H. & Pretorius, S. J. (1990). Ratio of Schistosoma haematobium to S. ntattheei in Bulks ufricanus snails from rural areas in the eastern Transvaal lowveld in South Africa. Transactions of the Royal Society of Tropical Medicine and Hygiene, 84, 556. Pitchford, R. J. (1961). Observations on a possible hybrid between the two schistosomesS. haemutobium and S. mattheei. Transactions of the Royal Sociery of Tropical Medicine and Hygiene, 55, 4&51. Pitchford, R. J. (1965). Differences in the egg morphology and certain biological characteristics of some African and Middle Eastern schistosomes, genus Schistosumz, with terminal-spined eggs. Bulletin of the World Health Organization, 32, 105-120.
Figure. Sectionof a granulomain a spinalcordmass.The prominent egg shell showsthe characteristic‘shoulders’of Scbisrosomamatcheei. (Haematoxylinand eosin stain.)
Received
7 August
1990; revised 30 October 30 October 1990
accepted for publication
1990;
TRANSACTIONS OF THE ROYALSOCIETYOF TROPICALMEDICINEAND HYGIENE(1991)85, 230
Occurrence mattheei-like lesion
of Schistosoma eggs in a spinal
cord
P. J. Fripp and J. Joubert
Departments of MicrobiologylParasitologv and Neurology, Medical University of Southern Africa, P.O. Medunsa 0204, Republic of South Africa
Schistosomiasis of the spinal cord may be a more common condition than is realised at Ga-Rankuwa Hospital situated 30 km north-west of Pretoria in the Transvaal province of South Africa. During the last 6 years, several casesof myelopathy of unknown origin have been seenin which the only relevant finding was positive schistosomiasisserology and where the condition subsequently responded to treatment with praziquantel (Biltricide@). Over a period of 3 years, 5 cases presented each with a lesion of the spinal cord and with positive cercarial fluorescent antibody serology. In 3 of these cases, surgery was performed and the routine histology reports noted granulomata containing unspecified schistosome eggsat different stagesof disintegration. There was no reference to the presence of adult flukes in the lesions. The histological sections were later reviewed. In one 9 years old female, in addition to both live and dead Schistosoma haematobium eggs, an occasional terminal-spined egg with pronounced ‘shoulders’ resembling S. mattheei was seen (Figure). At the time of the initial diagnosis, routine stool analysis had revealed schistosomeeggs which were identified as S. mattsoni; but no S. mat&xi eggs were reported, and eggs of S. haematobium had been found in the urine.
The patient was given a course of praziquantel and made a complete recovery. The patient came from Venda, a region adjacent to the northcru Transvaal, where S. mattheei is primari!! a oarasite of domestic and wild vertebrates. However, eggs may often be found in the faeces of children, notahlv herd-bovs. and in some areasof South Africa the prevalence $‘the human population may reach 40% (PITCHFORD, 1961). It probably does not occur as a pure infection in humans but only coexists with S. haematobium, when some degree of hybridization between S. haematobium males and S. mattheei females takes place (PITCHFORD, 1961, 1965; KRUGER, 1986; KRUGER et al., 1990). Table. Schistosoma haematobium and S. matieei: parison of egg lengths (in micrometers)
Free 83-187” S. haematobium 146259” s. fnattheei S. haematobium x S. mattheei 169 (sd=13) “From
PITCHFORD,
com-
Fixed 105-126b 147b
1965.
bThis paper. ‘From KRUGER et al., 1986; sd=standarddeviation. PITCHFORD (1965) showed that free ‘S. matthei’ (or S. haematobium x S. mattheei hybrid) eggs isolated
from human urine and faeces were larger than S. haematobium eggs in urine. Measurements of 9 eggs assumedto be c;t sagittally in the sections of the c&d lesion gave a mean length of 116 pm (105-126 pm). The length of the putative S. mattheei egg shown in the Figure, derived from measurementsin 2 adjacent sections, was 147 e, longer than the clearly identifiable S. haematobium eggs but shorter than free S. mattheei eggs (Table). If the ‘shoulders’ were fixation or sectioning artifacts, its length would be expected to be shorter than that of undistorted S. haematobium eggs. This seems to be the first record of the occurrence of S. mattheei or S. haematobium x S. mattheei hybrid eggs in a human spinal cord lesion. References
Gear, J. H. S,., Pitchford, R. J. & van Eeden, J. A. (l?SO). Atlas of Btlharzia. Johannesburg: South African Insutute for Medical Research. Kruger, F. J., Schutte, C. H. J., Visser, P. S. & Evans, A. C. (1986). Phenotypic differences in Schistosumo matthai ova from populations sympatric and allopatric to S. haematobium. Onderstepwrt Jouwtal of Veterkaty Research, 53, 10>107. Kruger, F. J., Joubert, P. H. & Pretorius, S. J. (1990). Ratio of Schistosoma haematobium to S. ntattheei in Bulks ufricanus snails from rural areas in the eastern Transvaal lowveld in South Africa. Transactions of the Royal Society of Tropical Medicine and Hygiene, 84, 556. Pitchford, R. J. (1961). Observations on a possible hybrid between the two schistosomesS. haemutobium and S. mattheei. Transactions of the Royal Sociery of Tropical Medicine and Hygiene, 55, 4&51. Pitchford, R. J. (1965). Differences in the egg morphology and certain biological characteristics of some African and Middle Eastern schistosomes, genus Schistosumz, with terminal-spined eggs. Bulletin of the World Health Organization, 32, 105-120.
Figure. Sectionof a granulomain a spinalcordmass.The prominent egg shell showsthe characteristic‘shoulders’of Scbisrosomamatcheei. (Haematoxylinand eosin stain.)
Received
7 August
1990; revised 30 October 30 October 1990
accepted for publication
1990;