A woman who underwent brain surgery for a host of medical complaints got far more than she bargained for when doctors pulled an eight-centimetre-long live worm from her brain.
The patient, a 64-year-old woman from New South Wales in Australia, was admitted to a Canberra hospital in January 2021 with complaints of weeks-long diarrhea and stomach pain, fever, night sweats and a dry cough that wouldn’t go away. A year later, she began to feel forgetful and increasingly depressed.
Concerned, doctors sent her for an MRI brain scan and the results found abnormalities that would require surgery.
“But the neurosurgeon certainly didn’t go in there thinking they would find a wriggling worm,” Dr. Sanjaya Senanayake, an infectious disease specialist and a colleague of the performing neurosurgeon, Dr. Hari Priya Bandi, told The Guardian.
“Neurosurgeons regularly deal with infections in the brain, but this was a once-in-a-career finding. No one was expecting to find that.”
The findings of the case are published in the September edition of the Emerging Infectious Diseases journal and the authors say the wriggling worm likely came after the woman unknowingly ingested the eggs of a parasitic roundworm often found in pythons in the area.
“The patient in this case resided near a lake area inhabited by carpet pythons. Despite no direct snake contact, she often collected native vegetation, warrigal greens, from around the lake to use in cooking,” the study reports. “We hypothesized that she inadvertently consumed (the) eggs either directly from the vegetation or indirectly by contamination of her hands or kitchen equipment.”
This case marks the first time the roundworm, Ophidascaris robertsi, has been documented in a human.
Senanayake told The Guardian, however, that removing the worm from the woman’s brain was just the first step — she also underwent other treatments, including medications, to ensure any other larvae that might have infiltrated her body were killed off.
“That poor patient, she was so courageous and wonderful,” Senanayake said. “You don’t want to be the first patient in the world with a roundworm found in pythons and we really take our hats off to her. She’s been wonderful.”
This first-of-its-kind case highlights how zoonotic diseases, once found only in wild animals, are increasingly finding their way into human populations.
“Of the emerging infections globally, about 75 per cent are zoonotic, meaning there has been transmission from the animal world to the human world. This includes coronaviruses,” Senanayake said.
He was quick to point out that it is not possible for an Ophidascaris infection to be transmitted between people, “so this patient’s case won’t cause a pandemic like COVID-19 or Ebola.”
“To our knowledge, this is also the first case to involve the brain of any mammalian species, human or otherwise,” he told Australian National University (ANU).
“Normally the larvae from the roundworm are found in small mammals and marsupials, which are eaten by the python, allowing the life cycle to complete itself in the snake.”
ANU associate professor Karina Kennedy said it’s important to practice food safety, particularly when gardening or foraging for food.
“People who garden or forage for food should wash their hands after gardening and touching foraged products. Any food used for salads or cooking should also be thoroughly washed, and kitchen surfaces and cutting boards, wiped down and cleaned after use,” she said.