Abstract
Co-infection with Schistosoma mansonii and Mycobacterium tuberculosis have been rarely reported in spite of the high African incidence of these two infections. We report the case of a 32 years old Mauritanian male living in France since 2001 who consulted with isolated abdominal pain. Rectal biopsies showed granuloma around Schistosoma mansonii eggs. He had persistent abdominal pain despite a treatment with Praziquantel , the biology stayed abnormal: elevated aspartate-(AST) and alanine transaminase (ALT), inflammatory syndrome and hypereosinophilia. Patient was explored for another diagnosis, 4 epigastric nodules were found and a punction is performed. Anatomopathology observed granulomatous lymphadenitis with necrosis, and positive acid-fast bacilli on excisional lymph node biopsy was found (culture showed Mycobacterium tuberculosis ). Tuberculous lymphadenitis diagnosis is then performed and standard anti-tuberculosis drugs are prescribed. Reviewing the literature on Schistosoma mansonii and Mycobacterium tuberculosis co-infections, one interrogate on the potential link between those two infections, specially on an immunophysiopathological basis. Described as an ulcerating mycobacteria, Schistosoma induce a specific cellular Th2-predominant immune response, on the opposite Mycobacteria's immunity which is rather Th1 cell-mediated related. The lymphocyte population imbalanced with Th2 could enhance susceptibility to mycobacterial diseases. This communication rounds up Schistosoma and Mycobacterium co-infection and studies the different physiopathological hypothesis for co-development.
Published Version
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