Health and Me

Tanya Dutt

Mysterious Burning Sensation In Woman’s Legs Turned Out To Be A Parasite In Her Brain

What started out as a relatively minor annoyance, a burning sensation in the feet, soon became a frightening health emergency for a New England woman aged 30. At first assuming her exhaustion and bizarre symptoms were due to jet lag after returning from a three-week vacation to Thailand, Japan and Hawaii, she was unaware that a parasitic infection was gripping her nervous system.

As the pain radiated from her feet to her legs, she found that even the slightest touch was excruciating. After several trips to the emergency room, physicians detected nothing particularly alarming, and she was sent home. But within days, her condition worsened, and confusion crept in a definite indication that something was terribly amiss. What ensued was a startling revelation- a deadly parasite had invaded her brain.

When the woman's burning sensation reached her torso and arms, with terrible headaches, she went for medical care once again. For the second time, routine tests—such as blood work and kidney function tests—were all normal, save for an abnormal level of eosinophils, a kind of white blood cell that is responsible for combating infection. Yet without definite proof of a parasite in her bloodstream, physicians were still stumped.

Her condition kept worsening. She became confused, fighting to understand where she was. Seeing the severity of her confusion, her partner had her taken to the hospital again. On this occasion, physicians did a lumbar puncture (spinal tap) to investigate her cerebrospinal fluid, the fluid that envelops the brain and spinal cord. The test measured an extremely high level of eosinophils indicating <span>eosinophilic meningitis</span>, a very uncommon form of brain inflammation usually caused by parasitic infections.

Through additional genetic testing of her cerebrospinal fluid, physicians ultimately diagnosed the cause: Angiostrongylus cantonensis, more commonly referred to as rat lungworm. This parasite occurs in tropical and subtropical areas, such as Hawaii, where the woman had just visited.

Rat lungworm has a complicated life cycle. The adults live within rodents, and the larvae of the worms are found in the feces of rodents. They get ingested by snails, slugs, and sometimes shellfish. Accidental host human beings consume contaminated raw or undercooked mollusks, tainted vegetables, or other contaminated foods. Upon being ingested within the human body, larvae have the potential to migrate into the brain and result in grave <span>neurological symptoms</span>.

<h2>How the Parasites Influence the Brain?</h2>

Although some individuals infected with A. cantonensis are asymptomatic, others experience severe complications as the parasite penetrates the central nervous system. In the woman's case, the infection resulted in eosinophilic meningitis, which may result in:

<ul><li>Severe headaches</li><li>Stiff neck</li><li>Vomiting</li><li>Confusion and loss of mental faculties</li><li>Seizures and vision problems</li></ul>

In laboratory tests, the parasite has been found to travel to the brain within four hours of being ingested. There, it causes inflammation, nerve damage, and often deadly complications. Although most infections clear up spontaneously as the parasites die, some will need treatment, especially if neurological symptoms are serious.

Due to the seriousness of her symptoms, physicians treated the woman with a 14-day regimen of antiparasitic medication to cure the infection. She was also given steroids to alleviate inflammation in her brain and spinal cord. She was stable enough after six days in the hospital to be discharged, although complete neurological recovery may take weeks or months.

<h2>Could This Dangerous Situation Been Prevented?</h2>

Rat lungworm infections are uncommon but may have catastrophic outcomes. The Centers for Disease Control and Prevention (CDC) advises the following precautions to reduce the risk of infection:

Do not eat raw or undercooked snails, slugs, frogs, shrimp, or prawns, as these can contain the parasite.

Wash fresh fruits and vegetables, particularly leafy greens, well to eliminate any possible contamination from slug or snail slime.

Wear gloves when touching snails or slugs in gardens, and wash hands afterward immediately.

Take care when consuming raw vegetables in tropical areas where the parasite is endemic.

This case is a horrific reminder of how one must exercise caution regarding potential health hazards during travel to areas where parasitic infections are endemic. Although infection with A. cantonensis is rare, it serves to remind us to be vigilant for food safety precautions and seek early medical attention whenever unusual symptoms appear.

Had the symptoms of the woman been brushed off for so long, the infection would have done irreparable harm to her neurological system. Thankfully, owing to her tenacity and the hard work of a committed medical team, she received treatment before it was too late. Her experience is a stark reminder that even a slight burning sensation may presage something far more nefarious lurking below the surface.

Health Conditions A-Z

health

rare disease

eosinophilic meningitis

rat lungworm infection

parasite in brain

neurological symptoms

burning leg sensation

travel-related infections

foodborne parasites

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What started out as a relatively minor annoyance, a burning sensation in the feet, soon became a frightening health emergency for a New England woman aged 30. At first assuming her exhaustion and bizarre symptoms were due to jet lag after returning from a three-week vacation to Thailand, Japan and Hawaii, she was unaware that a parasitic infection was gripping her nervous system.As the pain radiated from her feet to her legs, she found that even the slightest touch was excruciating. After several trips to the emergency room, physicians detected nothing particularly alarming, and she was sent home. But within days, her condition worsened, and confusion crept in a definite indication that something was terribly amiss. What ensued was a startling revelation- a deadly parasite had invaded her brain.When the woman's burning sensation reached her torso and arms, with terrible headaches, she went for medical care once again. For the second time, routine tests—such as blood work and kidney function tests—were all normal, save for an abnormal level of eosinophils, a kind of white blood cell that is responsible for combating infection. Yet without definite proof of a parasite in her bloodstream, physicians were still stumped.Her condition kept worsening. She became confused, fighting to understand where she was. Seeing the severity of her confusion, her partner had her taken to the hospital again. On this occasion, physicians did a lumbar puncture (spinal tap) to investigate her cerebrospinal fluid, the fluid that envelops the brain and spinal cord. The test measured an extremely high level of eosinophils indicating eosinophilic meningitis, a very uncommon form of brain inflammation usually caused by parasitic infections.Through additional genetic testing of her cerebrospinal fluid, physicians ultimately diagnosed the cause: Angiostrongylus cantonensis, more commonly referred to as rat lungworm. This parasite occurs in tropical and subtropical areas, such as Hawaii, where the woman had just visited.Rat lungworm has a complicated life cycle. The adults live within rodents, and the larvae of the worms are found in the feces of rodents. They get ingested by snails, slugs, and sometimes shellfish. Accidental host human beings consume contaminated raw or undercooked mollusks, tainted vegetables, or other contaminated foods. Upon being ingested within the human body, larvae have the potential to migrate into the brain and result in grave neurological symptoms.How the Parasites Influence the Brain?Although some individuals infected with A. cantonensis are asymptomatic, others experience severe complications as the parasite penetrates the central nervous system. In the woman's case, the infection resulted in eosinophilic meningitis, which may result in:Severe headachesStiff neckVomitingConfusion and loss of mental facultiesSeizures and vision problemsIn laboratory tests, the parasite has been found to travel to the brain within four hours of being ingested. There, it causes inflammation, nerve damage, and often deadly complications. Although most infections clear up spontaneously as the parasites die, some will need treatment, especially if neurological symptoms are serious.Treatment and RecoveryDue to the seriousness of her symptoms, physicians treated the woman with a 14-day regimen of antiparasitic medication to cure the infection. She was also given steroids to alleviate inflammation in her brain and spinal cord. She was stable enough after six days in the hospital to be discharged, although complete neurological recovery may take weeks or months.Could This Dangerous Situation Been Prevented?Rat lungworm infections are uncommon but may have catastrophic outcomes. The Centers for Disease Control and Prevention (CDC) advises the following precautions to reduce the risk of infection:Do not eat raw or undercooked snails, slugs, frogs, shrimp, or prawns, as these can contain the parasite.Wash fresh fruits and vegetables, particularly leafy greens, well to eliminate any possible contamination from slug or snail slime.Wear gloves when touching snails or slugs in gardens, and wash hands afterward immediately.Take care when consuming raw vegetables in tropical areas where the parasite is endemic.This case is a horrific reminder of how one must exercise caution regarding potential health hazards during travel to areas where parasitic infections are endemic. Although infection with A. cantonensis is rare, it serves to remind us to be vigilant for food safety precautions and seek early medical attention whenever unusual symptoms appear.Had the symptoms of the woman been brushed off for so long, the infection would have done irreparable harm to her neurological system. Thankfully, owing to her tenacity and the hard work of a committed medical team, she received treatment before it was too late. Her experience is a stark reminder that even a slight burning sensation may presage something far more nefarious lurking below the surface.