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256

Revista da Sociedade Brasileira de Medicina Tropical 40(2):256-257, mar-abr, 2007

Schistosomiasis of the uterine cervix

Esquistossomose do colo do útero

Fernando Crivelenti Vilar

1

, Giovana Bachega Badiale

2

and Benedito Antônio Lopes da Fonseca

1

IMAGENS EM DIP/IMAGES IN INFECTIOUS DISEASE

1. Divisão de Moléstias Infecciosas, Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP. 2. Serviço de Patologia, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.

Address to: Prof. Benedito Antonio Lopes da Fonseca. Dept°. de Clínica Médica do HC/FMRP/USP. Av. Bandeirantes 3900, Campus Universitário, 14048-900 Ribeirão Preto, SP. e-mail: [email protected]

Recebido para publicação em 14/9/2006 Aceito em 17/1/2007

A

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257

Vilar FC et al

A 35-year-old woman born in Medina (north of Minas

Gerais State) and living in Sertãozinho (20km from Ribeirão

Preto) sought medical care at the Sterility Clinic due to infertility

secondary to tubal ligation performed 15 years earlier. She

wished to have another pregnancy. Screening tests for infertility

detected an endocervical polyp that was surgically removed.

The anatomopathological examination revealed the presence

a large quantity of

Schistosoma sp

eggs. Figure A: Fragments

of uterine cervix showing a chronic granulomatous process

with giant cell reaction involving multiple eggs of

Schistosoma

sp

. Figure B: spiny egg of

Schistosoma sp

permeated by

inflammatory infiltrate consisting of epithelioid histiocytes,

plasma cells and neutrophils. Parasitological examination

of feces showed eggs of

Schistosoma mansoni

. The patient

was treated with praziquantel (60 mg/kg) divided in two doses.

She has remained asymptomatic.

A paciente, de 35 anos, natural de Medina (norte de Minas

Gerais) e procedente de Sertãozinho (20km de Ribeirão Preto),

procurou o ambulatório de esterilidade devido à infertilidade

secundária à laqueadura tubária há 15 anos. Desejava engravidar

novamente. Exames de triagem para infertilidade detectaram

pólipo endocervical que foi ressecado. O exame

anátomo-patológico revelava grande quantidade de ovos de

Schistosoma sp.

Figura A: Fragmentos de colo uterino exibindo processo crônico

granulomatoso com reação gigantocelular envolvendo múltiplos

ovos de

Schistosoma sp

; Figura B: Ovo espiculado de

Schistosoma

sp

permeado por infiltrado inflamatório constituído de histiócitos

epitelióides, plasmóciotos e neutrófilos. O exame parasitológico

de fezes mostrou ovos de

Schistosoma mansoni

. A paciente foi

tratada com praziquantel na dose de 60mg/kg de peso divididos

em duas tomadas, permanecendo assintomática.

REFERENCES

1. Adeniran A, Dimashkieh H, Nikiforov Y. Schistosomiasis of the cervix. Archives of Pathology and Laboratory Medicine 127:1637-1638, 2003.

2. Helling-Giese G, Kjetland EF, Gundersen SG, Poggensee G, Richter J, Krantz I, Feldmeier H. Schistosomiasis in women: manifestations in the upper reproductive tract. Acta Tropica 62: 225-238, 1996.

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