Diagnosis of neuroschistosomiasis by antibody specificity index and semi-quantitative real-time PCR from cerebrospinal fluid and serum

• Published in: Journal of medical microbiology Vol. 63; no. 2; pp. 309 - 312
• Main Authors: HÄRTER, Georg, FRICKMANN, Hagen, ZENK, Sebastian, WICHMANN, Dominic, AMMANN, Bettina, KERN, Peter, FLEISCHER, Bernhard, TANNICH, Egbert, POPPERT, Sven
• Format: Journal Article
• Language: English
• Published: Reading Society for General Microbiology 01-02-2014
• Subjects: Adolescent; Animals; Antibodies, Helminth - blood; Antibodies, Helminth - cerebrospinal fluid; Antibody Specificity; Biological and medical sciences; Diseases caused by trematodes; DNA, Helminth - cerebrospinal fluid; Emigrants and Immigrants; Fundamental and applied biological sciences. Psychology; Germany; Ghana; Helminthic diseases; Humans; Infectious diseases; Male; Medical sciences; Microbiology; Neuroschistosomiasis - diagnosis; Neuroschistosomiasis - parasitology; Neuroschistosomiasis - pathology; Parasitic diseases; Real-Time Polymerase Chain Reaction; Schistosoma - genetics; Schistosoma - immunology; Schistosomiases; Ghana; Germany; Antibody; Trematode disease; Parasitosis; Cerebrospinal fluid; Real time; Helminthiasis; Infection; Polymerase chain reaction; Schistosomiasis; Specificity; Serum; Diagnosis; Quantitative analysis
• ISSN: 0022-2615; 1473-5644
• DOI: 10.1099/jmm.0.066142-0

We describe the case of a 16-year-old German male expatriate from Ghana who presented with obstipation, dysuria, dysaesthesia of the gluteal region and the lower limbs, bilateral plantar hypaesthesia and paraesthesia without pareses. A serum-cerebrospinal fluid (CSF) Schistosoma spp. specific antibody specificity index of 3.1 was considered highly suggestive of intrathecal synthesis of anti-Schistosoma spp. specific antibodies, although standardization of this procedure has not previously been described. Diagnosis was confirmed by detection of Schistosoma DNA in CSF by semi-quantitative real-time PCR at 100-fold concentration compared with serum. Accordingly the two diagnostic procedures, which have not previously been applied for routine diagnosis, appear to be useful for the diagnosis of neuroschistosomiasis. Clinical symptoms resolved following anthelmintic and anti-inflammatory therapy.