Spinal cord Schistosomiasis in a 26-year-old male patient with progressive lower limb weakness and sensory loss: A case report

Spinal cord <i>schistosomiasis</i> is a rare but potentially devastating manifestation of <i>Schistosoma</i> infection, resulting from an inflammatory granulomatous response to parasite eggs trapped in the spinal cord. It poses a significant diagnostic challenge, often mimicking intramedullary tumors. We report the case of a 26-year-old male patient residing near Lake Victoria who presented with acute, progressive paraplegia, sensory loss, and autonomic dysfunction. Magnetic resonance imaging revealed a focal enhancing intramedullary lesion at the T12-L1 level. Given the diagnostic uncertainty, a decompressive biopsy was performed, which confirmed the presence of <i>Schistosoma mansoni</i> ova within a granulomatous infiltrate. The patient was treated with a combination of praziquantel and systemic corticosteroids, resulting in significant neurologic recovery. This case highlights the critical importance of maintaining a high index of suspicion for <i>schistosomiasis</i> in patients presenting with myelopathy and relevant epidemiologic exposure. Prompt diagnosis, aided by histopathology or serology, and early initiation of dual medical therapy are essential to prevent permanent neurologic sequelae.