A live worm has been discovered in the brain of an Australian woman. The woman had been experiencing memory issues and sadness prior to medical professionals removing an eight centimeter-long worm, typically found in pythons.
Medical experts were astonished when Dr. Hari Priya Bandi, a neurosurgeon, extracted the parasitic roundworm from the patient’s brain. The worm was alive and squirming, which prompted Dr. Bandi to seek advice from her colleagues, including Dr. Sanjaya Senanayake, who is an infectious diseases physician at Canberra Hospital.
Details of the patient
The patient, a 64-year-old woman from the southeastern region of New South Wales, initially sought care at her local hospital in late January 2021. She had been grappling with abdominal pain, diarrhea, and a persistent dry cough for three weeks.
As her condition progressed into 2022, she additionally faced memory problems and depression. Due to these worrisome symptoms, she was referred to Canberra Hospital. Subsequent MRI scans of her brain exposed abnormalities that necessitated surgical intervention.
Dr. Senanayake said, “But the neurosurgeon certainly didn’t go in there thinking they would find a wriggling worm.” He further said, “Neurosurgeons regularly deal with infections in the brain, but this was a once-in-a-career finding. No one was expecting to find that.”
live worm found in Australian woman’s brain in world-first discovery. Woman complained of forgetfulness and depression before doctors pulled out an 8cm roundworm normally found in pythons. pic.twitter.com/fq1m4omUrD
— Hossain Zamir | حسين ضمير (@HossainZamir2) August 28, 2023
Rapid collaboration among experts
The astonishing discovery spurred a rapid collaboration among the hospital’s experts, all driven to ascertain the specific type of roundworm and determine any necessary follow-up treatment for the patient.
“We just went for the textbooks, looking up all the different types of roundworm that could cause neurological invasion and disease,” stated Senanayake. However, their initial efforts proved unproductive, prompting them to seek assistance from external specialists.
“Canberra is a small place, so we sent the worm, which was still alive, straight to the laboratory of a CSIRO scientist who is very experienced with parasites,” revealed Senanayake. “He just looked at it and said, ‘Oh my goodness, this is Ophidascaris robertsi.'”
How did the patient get infected?
The patient resides in close proximity to a lake area populated by carpet pythons. Even though she had no direct contact with the snakes, she frequently gathered native grasses such as Warrigal greens from the lake’s vicinity for use in her cooking routines, as highlighted by Senanayake.
The medical professionals and researchers engaged in her case propose a hypothesis: a python likely excreted the parasite through its feces, which then found its way into the grass. This chain of events suggests that the patient may have become infected by touching the native grass or through consumption of the greens.
Dr. Senanayake emphasized that the patient necessitated treatment to address the possibility of other larvae invading different body parts, including the liver.
However, due to the unprecedented nature of this parasite’s impact on humans, a cautious approach was imperative. Some treatments could potentially trigger inflammation during the larvae’s termination.
As inflammation could pose risks to vital organs such as the brain, counteractive medications were also administered to mitigate any potential adverse effects.
Recovery of the patient
The patient’s recovery is progressing well, with consistent monitoring, as outlined by Senanayake. Researchers are actively investigating whether an underlying medical condition, which rendered the patient immunocompromised, might have facilitated the larvae’s establishment.
The documentation of this exceptional case is slated for publication in the upcoming September issue of the journal Emerging Infectious Diseases.
As highlighted by the US Centers for Disease Control and Prevention, a substantial seventy-five percent of novel or emerging infectious diseases in humans originate from animals.
Senanayake underscored that this unprecedented case exposes the peril posed by diseases and infections making their way from animals to humans. This danger looms larger as human and animal habitats increasingly intersect.
“Of the emerging infections globally, about 75 percent are zoonotic, meaning there has been transmission from the animal world to the human world,” he added. “This includes coronaviruses.”
“This Ophidascaris infection does not transmit between people, so this patient’s case won’t cause a pandemic like Covid-19 or Ebola,” he explained. “However, the snake and parasite are found in other parts of the world, so it is likely that other cases will be recognized in coming years in other countries.”
Professor Peter Collignon, an infectious diseases physician who was not directly associated with the patient’s case, highlighted that certain instances of zoonotic diseases could go undiagnosed, particularly if they are rare and physicians lack the necessary knowledge.
“Sometimes, people die with the cause never being found,” he cautioned. Collignon advocated for prudence when interacting with animals and the environment.
He recommended thorough washing of foods and proper cooking techniques, along with the use of protective attire like long sleeves to minimize the risk of bites.