Woman from Wales, Australia, Finds Parasitic Roundworm in Brain After Year of Deteriorating Health

Wednesday - August 30 2023, 23:34 UTC - 1 year ago

A 64-year-old woman from Wales, Australia, was admitted to a local hospital in 2021 due to abdominal pain, diarrhea, dry cough and night sweats. Her situation deteriorated over time and doctors were surprised to find an 8-centimeter-long parasitic roundworm from the woman’s brain. It was identified as a third-stage larva of Ophidascaris robertsi, which is usually found in snakes, pythons specifically. The woman must have consumed the roundworm eggs by either eating contaminated raw vegetables near a lake or becoming exposed to contaminated hands or kitchen equipment. Her case emphasizes the ongoing risk for zoonotic diseases.

A 64-year-old woman from Wales, Australia, started to complain of abdominal pain, diarrhea, dry cough and night sweats, three weeks after which she was admitted to a local hospital in January 2021. What followed was a year of shifting hospitals and her situation deteriorating. Bacterial, fungal, and mycobacterial cultures were negative. And tests done to determine parasite invasion on fecal specimens turned out to be negative. During a three-month period in two months, the patient experienced forgetfulness and worsening depression. A brain MRI showed a 13 × 10 mm right frontal lobe lesion. The doctors decided to perform an open biopsy. What they found surprised everyone in the operating room that day. They pulled out an 8-centimeter-long parasitic roundworm from the woman’s brain. The parasitic worm was identified as a third-stage larva of Ophidascaris robertsi.

The case of a live worm inside a brain had never been reported before. "But the neurosurgeon certainly didn’t go in there thinking they would find a wriggling worm," said Dr Sanjaya Senanayake, a physician in Canberra and colleague of the neurologist who performed the surgery. "Neurosurgeons regularly deal with infections in the brain, but this was a once-in-a-career finding. No one was expecting to find that." .

Another thing that surprised doctors was that Ophidascaris robertsi is usually found in snakes, pythons specifically. So, how did it find its way into that woman’s brain? .

"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," added Dr Senanayake in an interview with The Guardian. "He just looked at it and said, ‘Oh my goodness, this is Ophidascaris robertsi’." .

The patient’s history could be traced back to her residence near a lake area usually inhabited by carpet pythons. According to the journal Emerging Infectious Diseases, where this case has been documented, the woman did not have direct contact with the snake. She would collect vegetables from around the lake to use in cooking. It was concluded that the woman must have consumed Ophidascaris robertsi eggs either directly from the vegetables or indirectly by contamination of her hands or kitchen equipment.

"That poor patient, she was so courageous and wonderful," added Dr Senanayake. "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." .

As humans and animals are wound up in the same environments consistently, the woman’s case emphasizes the ongoing risk for zoonotic diseases. It’s expected that cases such as these may emerge globally.

"There have been about 30 new infections in the world in the last 30 years," said addd Dr Senanayake. "Of the emerging infections globally, about 75% are zoonotic, meaning there has been transmission from the animal world to the human world. This includes coronaviruses." .

However, he added, that diseases from Ophidascaris robertsi aren’t contagious like coronaviruses, so we don’t have to worry about a pandemic.