A case is reported of a female patient with hepatosplenic schistosomiasis mansoni, with commitment of the lungs, who died in severe dyspnea and cyanosis, without any sign of "fragmentatio cordis", after having taken a small dosis of antimonial. There were no clinical signs of congestive heart failure, although the data of the necropsy had suggested this diagnosis. The authors call attention to the quick aggravation of right ventricular hypertrophy, after the antimonial, and the disproportion between the clinical and anatomical picture of lungs commitment of the parasitosis. The differential diagnosis of cyanosis in cases of schistosomal lung disease, and the presence of thrombocytopenic purpura, jaundice and chronic glomerulonephritis in this case are discussed.