Neuroschistosomiasis: rare CNS infection in a preschool-aged child

Neuroschistosomiasis is a rare but severe manifestation of Schistosoma infection with a challenging diagnosis. We present a paediatric case of neuroschistosomiasis, presenting with persistent vomiting, headache and irritability for seven days. Fundoscopic examination revealed bilateral papilloedema. Brain MRI findings revealed mildly distended sheaths and tortuous optic nerve, suggesting intracranial hypertension. CSF manometry revealed high opening pressure. Schistosomiasis antibodies in blood and CSF were strongly positive. The patient demonstrated an excellent therapeutic response to serial CSF drainage, empirical praziquantel, acetazolamide and corticosteroid treatment. The child gradually improved without neurological sequelae. Prompt diagnosis and treatment are crucial for a favourable outcome and minimising the risk of permanent neurological impairment.