Woman's Mysterious Burning Feet Traced to Worms in Her Brain
The worms seem to have been unlucky souvenirs the woman unknowingly picked up while traveling in Thailand, Japan, and Hawaii.
Embedded in her central nervous system, the quiet invaders didn't 'make a peep' until 12 days after the woman had returned home. Only then did their presence cause an intense immune response that took a further week to diagnose.
Over several days, hot pain in the woman's feet crawled up her legs, trunk, and arms, before erupting in a splitting headache that even frequent doses of pain relief medication couldn't alleviate.
An initial visit to the emergency department turned up only a mild increase in disease-fighting white blood cells. But after days of unrelenting discomfort and a mild fever, the woman returned to a different hospital looking for answers.
Following treatment with intravenous anti-inflammatories and an anti-anxiety medication called lorazepam, her headache finally abated and she was discharged.
Once again, the symptoms persisted.
The next morning, when the woman woke, she began to pack for a vacation that she had not planned. Her roommate noticed her strange behavior and encouraged her to lie back down in bed. Hours later, when the woman was still showing signs of confusion, her partner took her to hospital.
"The development of confusion in this patient with sensory symptoms, headache, and possible intermittent fever suggests the possibility of encephalitis and further increases concern about a central nervous system infection," explains infectious disease specialist Joseph Zunt from the University of Washington.
Testing her blood, her doctors found no sign of parasites, and a CT scan of her head showed no red flags beneath her skull. Yet when medical staff performed a lumbar puncture, they found the patient's cerebrospinal fluid (CSF), which bathes the brain and spinal cord, contained markers of eosinophilic meningitis – a rare form of brain infection that can be caused by parasites.
Based on the patient's recent travel and her symptoms, her doctors agreed she met the criteria for a presumptive diagnosis of angiostrongyliasis.
This insidious disease is also known as rat lungworm because it is caused by the parasite Angiostrongylus cantonensis, which starts its life cycle in the lungs of a rodent before spreading to slugs and snails.
Most people aren't eating uncooked slugs or snails, but if we bite into a fresh, leafy vegetable that one of these creatures has slimed, the parasite's larvae can end up in our bodies without us knowing it.
That's one of the reasons why washing green produce is so important when staying in parts of the world where rat lungworm spreads, including Southeast Asia, the Pacific Islands, and Australia. Undercooked crab or prawns can also be a vector, as these animals eat slugs and snails, too.
When the parasites infect human bodies, they can migrate to the pulmonary arteries, swimming into the central nervous system and threatening the life of the host.
Only occasionally are the larvae able to be seen in the brain for a definitive diagnosis. Usually, brain scans only hint at damage from these parasites. The image below, for instance, shows clear signals of lesions in parts of a 32-year-old's brain that are indicative of angiostrongyliasis.
Thankfully, the woman in the US had her brain saved from parasites by a two-week course of drugs that can cross the blood-brain barrier to treat angiostrongyliasis. The patient was also given a high dose of a steroid called prednisone to help alleviate inflammation in her brain.
Her symptoms abated with the combination treatment, and on her sixth day in hospital, she was able to go home – this time without hidden passengers in her brain.
The study was published in the New England Journal of Medicine.
World's Most Common Painkiller During Pregnancy Linked to ADHD
Female Physicians Are Dying by Suicide at Astonishingly High Rates
Study Finds Humans Age Faster at 2 Sharp Peaks – Here's When
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
NBC News
a day ago
- NBC News
Man who asked ChatGPT about cutting out salt from his diet was hospitalized with hallucinations
A 60-year-old man spent three weeks being treated at a hospital after replacing table salt with sodium bromide following consultation with a popular artificial intelligence chatbot. Three physicians published a case report on the matter in the Annals of Internal Medicine earlier this month. According to the report, the man had no prior psychiatric history when he arrived at the hospital "expressing concern that his neighbor was poisoning him." The man shared that he had been distilling his own water at home and the report noted he seemed "paranoid" about water he was offered. Bromism, or high levels of bromide, was considered after a lab report and consultation with poison control, the report said. "In the first 24 hours of admission, he expressed increasing paranoia and auditory and visual hallucinations, which, after attempting to escape, resulted in an involuntary psychiatric hold for grave disability," the case report said. Once his condition improved, the man shared that he had taken it upon himself to conduct a "personal experiment" to eliminate table salt from his diet after reading about its negative health effects. The report said he did this after consulting with ChatGPT, an artificial intelligence bot. He self-reported that the replacement went on for three months. The three physicians, all from the University of Washington, noted in the report that they did not have access to the patient's conversation logs with ChatGPT. However, they asked ChatGPT 3.5 on what chloride could be replaced with on their own. According to the report, the response they received included bromide. "Though the reply stated that context matters, it did not provide a specific health warning, nor did it inquire about why we wanted to know, as we presume a medical professional would do," the report said. A representative for OpenAI, the company that created ChatGPT, did not immediately respond to a request for comment. The company noted in a statement to Fox News that its terms of service state that the bot is not to be used in the treatment of any health condition. "We have safety teams working on reducing risks and have trained our AI systems to encourage people to seek professional guidance," the statement said. Bromide toxicity was a more common toxic syndrome in the early 1900s, the report said, as it was present in a number of over-the-counter medications. It was believed to contribute to 8% of psychiatric admissions at the time, according to the report. It's a rare syndrome but cases have re-emerged recently "as bromide-containing substances have become more readily available with widespread use of the internet," the report said.
Yahoo
2 days ago
- Yahoo
Moving to a walkable city can add more than 1,000 steps to your day: Study
People who moved to cities with better walkability logged about 1,100 more steps per day and were nearly twice as likely to meet exercise goals, according to a large U.S. relocation study published in the journal Nature on Wednesday. Researchers from the University of Washington and Stanford University tracked about 5,500 Americans of all ages and fitness levels as they moved between 1,600 U.S. cities, monitoring their activity for 90 days before and after the move, from 2013 to 2016. Using smartphone step counts and the Walk Score system, which rates locations from 0 to 100 based on access to amenities like stores, parks and schools, they found that moving from a low-walkability city (48 or less) to a high-walkability one (75 or more) added an average of 1,100 steps a day. That equated to roughly 11 extra minutes of walking per day, or about one additional hour of moderate-to-vigorous physical activity per week. The biggest jump came from moves to places like New York City, where a Walk Score of 89 translated to daily steps climbing from about 5,600 to 7,000. "We were positively surprised by the size of that effect," Tim Althoff, the lead author of the study and an associate professor at the University of Washington in the Paul G. Allen School of Computer Science & Engineering, said. "On average, people walked about 1,400 steps every day more when they moved to New York, or if they moved [in] the opposite direction, they lost about 1,400 steps a day." MORE: Why gentle exercise like yoga, tai chi and walking may help people sleep better However, Althoff noted that not all steps are created equal. "Most of the difference actually was in this kind of brisk walk regime that is considered moderate or above," he said. In those who moved from low- to high-walkability cities, the proportion who met the U.S. physical activity guidelines increased from 21.5% before relocation to 42.5% after relocation. Many also moved closer to the CDC's recommended 150 minutes of moderate intensity physical activity a week or roughly 8,000 steps of brisk walking. If all U.S. cities matched Chicago's or Philadelphia's walkability (Walk Score 78), 36 million more Americans could meet national activity targets, a simulation performed as part of the study found. If cities matched New York City's walkability (89), that number could rise to 47 million. One group, however, did not see a step-count bump: women over 50. The researchers suggested this could stem from safety concerns, caregiving responsibilities and poor transit access. "Improving the built environment is a great start, but it's not kind of this one size fits all improvement that benefits absolutely everybody," Althoff said. "It still needs to be paired with targeted health intervention." MORE: Just 5 extra minutes of intense exercise may help lower blood pressure, study predicts In the U.S., more than 8% of all deaths are linked to insufficient physical activity, which is associated with about $117 billion in annual healthcare costs, according to the CDC. "Physical inactivity is the fourth underlying cause of death in the world and in the country because it contributes to so many chronic diseases as well as infectious diseases and mental health conditions," James Sallis, distinguished professor emeritus at the School of Public Health, University of California at San Diego, said. Sallis stressed that walkability is about giving people safe ways to reach their destinations without relying on a car. "Hopefully a study this large and this impressive will help convince city leaders that not making good conditions for walking is really doing a disservice to the residents," he said. The study's findings highlight the ways in which urban design can significantly influence physical activity and population health, according to Althoff. "Helping city planners and policymakers know exactly where to direct resources and for the best results of the health of large populations in the cities is a key part," he said. Ashish Bibireddy, MD, MPH is an internal medicine resident at The Mount Sinai Hospital and a member of the ABC News Medical Unit. Solve the daily Crossword
2 days ago
Moving to a walkable city can add more than 1,000 steps to your day: Study
People who moved to cities with better walkability logged about 1,100 more steps per day and were nearly twice as likely to meet exercise goals, according to a large U.S. relocation study published in the journal Nature on Wednesday. Researchers from the University of Washington and Stanford University tracked about 5,500 Americans of all ages and fitness levels as they moved between 1,600 U.S. cities, monitoring their activity for 90 days before and after the move, from 2013 to 2016. Using smartphone step counts and the Walk Score system, which rates locations from 0 to 100 based on access to amenities like stores, parks and schools, they found that moving from a low-walkability city (48 or less) to a high-walkability one (75 or more) added an average of 1,100 steps a day. That equated to roughly 11 extra minutes of walking per day, or about one additional hour of moderate-to-vigorous physical activity per week. The biggest jump came from moves to places like New York City, where a Walk Score of 89 translated to daily steps climbing from about 5,600 to 7,000. "We were positively surprised by the size of that effect," Tim Althoff, the lead author of the study and an associate professor at the University of Washington in the Paul G. Allen School of Computer Science & Engineering, said. "On average, people walked about 1,400 steps every day more when they moved to New York, or if they moved [in] the opposite direction, they lost about 1,400 steps a day." However, Althoff noted that not all steps are created equal. "Most of the difference actually was in this kind of brisk walk regime that is considered moderate or above," he said. In those who moved from low- to high-walkability cities, the proportion who met the U.S. physical activity guidelines increased from 21.5% before relocation to 42.5% after relocation. Many also moved closer to the CDC's recommended 150 minutes of moderate intensity physical activity a week or roughly 8,000 steps of brisk walking. If all U.S. cities matched Chicago's or Philadelphia's walkability (Walk Score 78), 36 million more Americans could meet national activity targets, a simulation performed as part of the study found. If cities matched New York City's walkability (89), that number could rise to 47 million. One group, however, did not see a step-count bump: women over 50. The researchers suggested this could stem from safety concerns, caregiving responsibilities and poor transit access. "Improving the built environment is a great start, but it's not kind of this one size fits all improvement that benefits absolutely everybody," Althoff said. "It still needs to be paired with targeted health intervention." In the U.S., more than 8% of all deaths are linked to insufficient physical activity, which is associated with about $117 billion in annual healthcare costs, according to the CDC. "Physical inactivity is the fourth underlying cause of death in the world and in the country because it contributes to so many chronic diseases as well as infectious diseases and mental health conditions," James Sallis, distinguished professor emeritus at the School of Public Health, University of California at San Diego, said. Sallis stressed that walkability is about giving people safe ways to reach their destinations without relying on a car. "Hopefully a study this large and this impressive will help convince city leaders that not making good conditions for walking is really doing a disservice to the residents," he said. The study's findings highlight the ways in which urban design can significantly influence physical activity and population health, according to Althoff. "Helping city planners and policymakers know exactly where to direct resources and for the best results of the health of large populations in the cities is a key part," he said.
