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Pulmonary nodules on CT scan of the lungs in acute schistosomiasis

In the article by Waldman et al [1] the authors state that, to their knowledge, proximal and subpleural nodules found by them on CT of a patient with "subacute" schistosomiasis had not been described in the literature.

Our intention is to complement their report showing that similar alterations during the acute phase of schistosomiasis have been described in Brazil [2, 3].

In the paper of Lambertucci et al [2], pulmonary abnormalities were described in three patients, including nodules and partchy infiltrates, on thoracic CT.

It may also interest your readers to know that acute schistosomiasis is not rare in endemic areas for this disease. The concept that acute schistosomiasis is a disease of tourists from non-endemic countries who travel to endemic areas is outdated. It is correct to say that tourists coming from non-endemic countries may develop acute schistosomiasis when they visit endemic countries but it is a mistake to believe that people living in large cities of endemic countries such as Brazil do not get acute schistosomiasis. Much of the population of Brazil react like tourists coming from abroad. They have had no previous contact with the parasite, contract the infection and develop acute schistosomiasis [4, 5].

More extensive use of CT for schistosomiasis in endemic areas will probably show that pulmonary involvement in the initial phase of the disease is not a rarity.

Yours etc.,

J R Lambertucci

Faculty of Medicine, Federal University of Minas Gerais, Infectious Diseases Branch, Brazil

Received for publication January 24, 2002. Accepted for publication February 6, 2002.

References

1. Waldman ADB, Day JH, Shaw P, Bryceson ADM. Subacute pulmonary granulomatous schistosomiasis: high resolution CT appearances—another cause of the halo sign. Br J Radiol 2001;74:1052–5.[Abstract/Free Full Text]
2. Lambertucci JR, Rayes AA, Barata CH, Teixeira R, Gerspacher-Lara G. Acute schistosomiasis: report on five singular cases. Mem Inst Oswaldo Cruz 1997;92:631–5.[Medline]
3. Lambertucci JR, Barata CH, Rayes AA. Unusual manifestations of acute schistosomiasis. Arq Bras Med 1996;70:45–9.
4. Lambertucci JR. S. mansoni: pathological and clinical aspects. In: P Jordan, R Sturrock, G Webbe, editors. Human Schistosomiasis. London: CAB International, 1993:160–82.
5. Barata CH, Pinto-Silva RA, Lambertucci JR. Abdominal ultrasound in acute schistosomiasis. Br J Radiol 1999;72:949–52.[Abstract]

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