A 40-year-old woman with rapid onset of flaccid paraplegia

A 40-year-old woman with paralysis of the legs, incontinence, and lower back pain was found to have schistosomiasis involving a Schistosoma mansoni infection of the spinal cord and colon. S. mansoni are parasitic worms that lay eggs that can remain in the body for many years. The worms are common in Brazil, where this woman had lived and visited. Magnetic resonance imaging and CT scans showed abnormal tissue and expansion of the spinal cord at the chest level. Biopsies of the lower colon showed clumps of blood and lymph cells around imbedded eggs, typical of schistosomiasis. Blood tests for the worms were positive. The woman was treated with praziquantel and her condition improved, though she experienced a relapse several months later. She was treated with the drug again, for a week, and was able to walk 10 feet without assistance.