Introduction
In medical mysteries, some cases baffle even experienced doctors and scientists. In Australia, an unusual experience by a woman led to a groundbreaking discovery that is changing our understanding of brain health and parasites. An 8 cm long live worm found in her brain, a first-of-its-kind event, has surprised the medical community and challenged what we know about the human brain.
Beginning of the Journey
It was an ordinary day for an infectious disease physician at Canberra Hospital until he received an unexpected call from a neurosurgeon colleague. The colleague’s words were astonishing: “You won’t believe what I’ve just discovered in this lady’s brain—it’s alive and wriggling.”
This neurosurgeon, who had extracted an 8cm-long parasitic roundworm from her patient, contacted the physician and their fellow hospital colleagues for guidance on the subsequent steps. A 64-year-old woman from the southeastern region of New South Wales initially sought medical attention in late January 2021 at her local hospital due to three weeks of abdominal pain and diarrhea. Subsequently, she developed a persistent dry cough, fever, and night sweats.
In 2022, her symptoms escalated to forgetfulness and depression, leading to a referral to Canberra Hospital. An MRI scan of her brain unveiled abnormalities that necessitated surgical intervention.
“But the neurosurgeon didn’t enter with the expectation of encountering a wriggling worm,” Physician mentioned. “Neurosurgeons frequently address brain infections, but this was an exceedingly rare discovery, a once-in-a-lifetime occurrence. Nobody had anticipated such an outcome.”
The unexpected finding made the hospital team gather urgently to determine the type of roundworm and the treatment the patient needed. “We checked the textbooks for information on roundworms that could affect the brain,” the doctor explained. They couldn’t find the needed answers, so they contacted experts outside the hospital for assistance.
The Diagnosis That Defied Expectations
“Because Canberra is a small area, the team promptly dispatched the live worm to the laboratory of a CSIRO scientist with extensive parasite expertise,” the specialist explained. “Upon examining it, he exclaimed, ‘My goodness, this is Ophidascaris robertsi!‘”
A typical roundworm that is commonly found in pythons. The patient at Canberra Hospital represents the world’s first documented case of this parasite being discovered in humans. The patient resides near a lake area inhabited by carpet pythons. Despite not having direct contact with snakes, she frequently gathered native grasses, including warrigal greens, from the vicinity of the lake for culinary purposes, as noted by specialists.
The doctors and scientists involved in her case have proposed a hypothesis suggesting a python may have excreted the parasite in its faeces onto the grass. They suspect that the patient likely became infected with the parasite by handling the native grass and subsequently transferring the eggs to food, kitchen utensils, or by consuming the greens.
The infectious diseases specialist from the Australian National University emphasized the necessity of treating the patient for potential larvae that might have invaded other areas of her body, like the liver. However, caution was exercised since no patient had ever received treatment for this parasite previously. Certain medications, for instance, had the potential to induce inflammation as the larvae perished. Inflammation could pose risks to vital organs like the brain, so they also had to provide medications to counteract any potentially harmful side effects.
Unprecedented Human Roundworm
Describing the patient, the specialist praised her courage and resilience in an exceptional situation. He emphasized the uniqueness of her case, being the first known instance of a roundworm typically found in pythons being present in a human. Her recovery is progressing well, with ongoing monitoring. Researchers are investigating the possibility that a pre-existing medical condition compromising her immune system might have facilitated the larvae’s infestation. This groundbreaking case has been documented in the September edition of the Emerging Infectious Diseases journal.
As per the U.S. Centers for Disease Control and Prevention, most new or emerging infectious diseases in humans originate from animals. The team underscored the growing concern of diseases and infections transferring from animals to humans due to the increasing proximity and overlapping of human and animal habitats.
A Lesson in Vigilance
Over the past 30 years, there have been approximately 30 new infections globally. Among these emerging infections, about 75% are zoonotic, meaning they originate from animals and spread to humans, including coronaviruses.
It’s important to note that Ophidascaris infection, unlike diseases like COVID-19 or Ebola, does not have human-to-human transmission potential, so it won’t lead to a pandemic. However, since the snake and parasite exist in various parts of the world, similar cases will likely surface in other countries in the coming years.
According to a famous infectious diseases physician who was not involved in the patient’s case, some zoonotic diseases, particularly rare ones, may go undiagnosed, leaving the cause unknown. Taking precautions when interacting with animals and the environment is advisable, including thorough food washing, proper cooking, and using protective measures like wearing long sleeves to prevent bites.
As a specialist, have you ever encountered such a rare case in your professional experience?
References
‘Oh my god’: live worm found in Australian woman’s brain in world-first discovery. (Accessed September 25, 2023) Available at: https://www.theguardian.com/australia-news/2023/aug/28/live-worm-living-womans-brain-australia-depression-forgetfulness
