Intramedullary Schistosomiasis Presenting in an Adolescent With Prolonged Intermittent Back Pain

A 14-year-old boy traveling from Guinea presented with a 2-month history of stable lower back pain. His neurologic examination was significant only for mild weakness in the distal lower extremities. He manifested peripheral eosinophilia, and magnetic resonance imagining revealed enlargement of the caudal aspect of the spinal cord and conus. A presumptive diagnosis of spinal schistosomiasis was rendered, and appropriate medication was administered before obtaining positive serology results. The patient's signs rapidly resolved. Spinal schistosomiasis should be considered in the differential diagnosis of any child with back pain and an appropriate travel history.