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

Spinal cord schistosomiasis is a rare but potentially devastating manifestation of Schistosoma 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 Schistosoma mansoni 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 schistosomiasis 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.