A WOMAN who complained of a burning sensation in her feet after returning home from a trip abroad was revealed to have parasitic worms in her brain.
The 30-year-old woman had just returned from a trip to Thailand, Japan and Hawaii when she began experiencing an unusual set of symptoms.
Her first symptom was fatigue, which she put down to jet lag.
But when she began experiencing headaches and a burning sensation in her feet, which travelled up to her legs and “worsened with light touch”, she was admitted to hospital.
The woman, from New England in the US, visited two hospital emergency rooms with symptoms, but doctors didn’t deem her condition serious enough to admit her.
She was then sent home with headache and anxiety medicine.
The woman didn’t return to hospital for more testing until she developed confusion.
Eventually, she was diagnosed with angiostrongyliasis – a parasitic infection caused by the roundworm Angiostrongylus cantonensis, commonly known as rat lungworm.
Most people get mild or no symptoms, but the parasite can infect your brain and cause headaches, neck stiffness, vomiting and brain and nerve issues.
Sometimes the worm can cause eosinophilic meningitis.
The woman’s case was published in the New England Journal of Medicine.
Dr Carlos A. Portales Castillo, who eventually treated her at Massachusetts General Hospital, was one of the authors of the case study.
According to the journal, Dr Joseph Zunt, a neurologist and infectious specialist looked at what caused the woman’s angiostrongyliasis
The first week of the woman’s travels was spent in Bangkok, Thailand, where she explored the city and enjoyed various street foods, but avoided raw dishes.
She then spent five days in Tokyo, Japan, mostly staying in her hotel and enjoying sushi for many of her meals.
In Hawaii “she swam in the ocean several times and frequently ate both salad and sushi,” said Castillo.
Zunt wrote the rat lungworm parasite is “endemic” in Hawaii and easily acquired.
“Infection can be acquired through multiple sources: ingestion of raw or undercooked infected snails or slugs; ingestion of vegetables or fruits contaminated by infected snails, slugs, or flatworms or by slime from snails or slugs that contains infectious larvae; or ingestion of infected paratenic hosts (e.g., land crabs, freshwater prawns, or frogs) that have consumed an infected snail,” he said.
Snails and slugs can pick up the infection from the faeces of infected rats, who may also contract it from eating an infected snail.
Rats also vomit the eggs from their lungs and then eat them – the journal notes it’s a “complicated life cycle”.
The patient was treated with steroid prednisone, an anti-parasite medication that suppresses the immune system, and after six days was discharged from hospital.
Rat lungworm is considered rare in humans in the UK, but it’s worth knowing the symptoms below…
Rat lungworm symptoms
ACCORDING to the Hawaii Department of Health, symptoms can start with non-specific symptoms and evolve to more specific symptoms over the next following weeks.
People may experience the following:
- nausea
- vomiting
- abdominal pain a few hours to a few days after ingestion
Symptoms can then progress to headache and other neurologic symptoms.
Non-specific symptoms include:
More specific symptoms may include:
- constant headache
- neck stiffness and pain
- tingling or burning of the skin
- double vision
- bowel or bladder difficulties
- seizures
Children may experience more fever, irritability, somnolence, lethargy, gastrointestinal symptoms, muscle twitching, convulsions, and extremity weakness.
In addition, individuals may experience a few days to weeks of no symptoms followed by neurologic symptoms.
Although it varies from individual to individual, the symptoms usually last between two to eight weeks, although symptoms have also been reported to last for longer periods of time.
