The patient's motor function and sensation improved by the second treatment day. On May 15, she began moving both extremities against gravity. On June 8, the patient was ambulating with assistance at a spinal rehabilitation center. Eosinophilic pleocytosis in the CSF is suggestive of schistosomiasis of the CNS but is often not observed, as in the cases reported here. How eggs, which are normally oviposited in the venules of the inferior mesenteric vein of the portal system, reach the spinal vascular system is unknown.
Treatment destroys the adult worms and thereby prevents further oviposition.
When evaluating persons for infection with schistosomes, interpretation of negative tests may be difficult, since extremely mild infections or ectopic localization of worms may preclude detection of eggs with stool or urine examinations. Because of the potential benefit of the recommended therapy, presumptive treatment of patients with diagnoses of transverse myelitis and histories of water exposure in endemic areas should be initiated while awaiting results of parasitologic or serologic tests. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the original MMWR paper copy for the official text, figures, and tables. Contact GPO for current prices.