Partial hypotrophy of the posterior and lateral columns of the spinal cord, representing a sequela of schistosomiasis mansoni: report of an autopsied case and a review of the literature.

An autopsied case of schistosomiasis mansoni of the spinal cord is reported. The patient had been healthy until about five years before, when he presented with paraparesis, loss of sensibility from the pelvic girdle down and fecal and urinary incontinence which persisted until death. At autopsy there was old necrosis of most of the gray matter in the middle thoracic segment of the spinal cord and severe hypotrophy of the posterior columns in the lumbar spinal cord, of the posterior and anterior spinocerebellar tracts, and of the lateral corticospinal tract, unilaterally, in the entire thoracolumbar spinal cord from the middle thoracic segment on. In correspondence with these lesions, over one hundred Schistosoma mansoni ova were found. No parasitism by S. mansoni in the brain and in the abdominal and thoracic viscera was found. This case is compared to others in the literature and a schistosomal etiology for spinal lesions is proposed. These lesions could represent a sequela of the prolonged destructive action of the granulomatous inflammatory process. The topography of the lesions, the relationship of schistosomiasis of the spinal cord to other anatomo-clinical forms of the disease, and how the spinal cord is reached by S. mansoni are commented upon.