Worm Survives Extraction From Woman’s Brain

The worm is native to Australia but typically infects pythons
Infected python feces contaminated local vegetation, including a spinach-like plant local people gather called warrigal greens

Trichinella is another type of roundworm infection humans can acquire from eating uncooked or undercooked meat containing the larvae

Roundworm infections may require specialized medications to treat and eradicate larvae

(NewsReady.com) – A 64-year-old woman living in New South Wales, Australia, consulted doctors in January 2021 after she suffered abdominal pains, diarrhea, a dry cough, and night sweats for three weeks. In June 2022, after more than a year of diagnostics and investigation, a neurosurgeon performed an exploratory surgery based on abnormal imaging results. The surgeon found something shocking and previously unreported: a 3-inch live worm in the woman’s brain.

Solving a Medical Mystery

In an article in “Emerging Infectious Diseases,” the medical team described the patient’s medical journey. After the woman presented with her symptoms, doctors treated her for a rare lung infection called eosinophilic pneumonia, but they told her they couldn’t determine the cause. Medically, they use the term “idiopathic” to describe the uncertain heritage of the condition. The doctors prescribed prednisone, a steroid, which the Cleveland Clinic described as a typical management step.

Yet, the patient’s condition continued to deteriorate. CT imaging showed lesions on her lungs, spleen, and liver and migrating lesions on her lungs that doctors couldn’t explain.

Additionally, her bloodwork began displaying markers for Hypereosinophilic Syndrome (HES), a very rare condition where white blood cells accumulate and begin damaging organs — essentially an autoimmune disease. Doctors increased steroid doses to suppress her immune system in response and added other drugs specifically designed to suppress her production of eosinophils, the white blood cells causing the problems.

Unfortunately, the patient experienced forgetfulness and worsening depression despite continuing a regimen of medications to suppress her immune response. An MRI showed a lesion in her right frontal lobe that doctors couldn’t explain, and the team decided to perform an exploratory surgery to examine it.

When Dr. Hari Priya Bandi touched the part of the patient’s brain that showed up strangely on images, she said, “gosh, that feels funny, you couldn’t see anything more abnormal.” Using tweezers, she pulled on what appeared to be a fiber, only to find a 3-inch-long worm, alive and wiggling. “Everyone was shocked. And the worm that we found was happily moving, quite vigorously, outside the brain,” the neurosurgeon recalled.

A Roundworm From a Carpet Python

The surgical team believes theirs was the first case where a surgeon removed a live parasitic worm from a human brain. Based on its red coloring and other physical attributes, the team identified it as a third-stage larva of Ophidascaris robertsi, a roundworm parasite that typically infests carpet pythons.

The patient lives near a lake inhabited by carpet pythons. Even though she had no contact with any of the snakes, she often gathered warrigal greens from around the lake to eat. The medical team believes she consumed the roundworm eggs from python droppings on the warrigal greens, either directly or through cross-contamination in the kitchen or on her hands.

Based on her description of symptoms and imaging, the medical team now believes the evidence of lesions they saw in different organs, traveling throughout her body, and evidenced by her high white blood cell counts, indicated the presence of larval worms in the patient’s body. After the team found the worm in the woman’s brain, they administered targeted medications that kill those types of parasites.

The team continues to monitor the woman. Yet, one team member, Associate Professor Sanjaya Senanayake, commented with admiration and empathy for her. “It is never easy or desirable to be the first patient in the world for anything. I can’t state enough our admiration for this woman who has shown patience and courage through this process.”