INTRODUCTON: Schistosomiasis or snail fever is one of the important tropical disease problems. It is a long drawn debilitating disease closely related to the personal habits and livelihood requiring frequent contact with the fresh water. Morbidity and mortality due to schistosomiasis are known to reduce productivity that leads to heavy economic loss. Likewise it is known to claim 1.75 lives out of every 100 individuals afflicted with the disease, if left untreated. This paper emphasizes the importance of differential diagnosis of schistosomiasis in a patient who has spent time in an endemic area.CASE REPORT: A 56 year old agriculturist, Filipino male from Samar presented with progressive difficulty in urination, followed by numbness of perineal, gluteal and left posterior thigh accompanied by erectile dysfunction one month prior to admission. Digital rectal examination showed lax sphincteric tone and enlarged prostate. Neurological examination revealed hyperrdlexia of knee jerk, areflexia of ankle jerk and hypoesthesia of both feet and perineal area with bilateral mute toe. The rest of the findings were normal. Lumbosacral MRI showed heterogenons enhancing intramedullary mass lesion at the level of T12-L1 which involves the conus medullaris with cord edema. Laminectomy for intramedullary tumor at T12-L1 followed by rush frozen section was done. On opening, it was noted that the grayish intramedullary mass was noted at the L1 vertebral body. Rush frozen section showed intramedullary tumor consistent with malignant lymphoma. However, after further evaluation, the mass revealed schistosomiasis. Hence, he was then treated with Praziquantel.CONCLUSION: Schistosomiasis of the spinal cord should be considered in the differential diagnosis of lesions affecting the lower thoracic cord-conus medullaris and cauda equina in patients from endemic areas with history of exposure to Schistosomal infestation.
Human ; Male ; Middle Aged ; Schistosomiasis ; Parasitic Diseases ; Helminthiasis ; Trematode Infections ; Central Nervous System Parasitic Infections ; Central Nervous System Helminthiasis ; Diagnosis ; Spinal Cord ; Neuroschistosomiasis ; Lymphoma ; Neoplasms ; Neoplasms By Histologic Type