Live worm found in Australian woman’s brain for the first time

Neurosurgeon Dr. Hari Priya Bandi extracted an 8 cm parasitic roundworm from her patient, prompting her to turn to Canberra Hospital infectious disease specialist Dr. Sanjaya Senanayaka and other hospital colleagues for advice on what to do next: “Oh my God, you won’t believe what I just found in the lady’s brain is alive and wriggling!”

As writes The Guardiana 64-year-old patient from southeast NSW was first admitted to a local hospital in late January 2021 after three weeks of abdominal pain and diarrhea accompanied by persistent dry cough, fever and night sweats.

By 2022, her symptoms also included forgetfulness and depression, prompting her to go to a Canberra hospital. Magnetic resonance imaging revealed abnormalities in the brain requiring surgical intervention.

“But the neurosurgeon certainly didn’t think he would find a writhing worm,” says Dr. Senanayake. “Neurosurgeons regularly deal with brain infections, but this was a rare discovery.”

It prompted the hospital team to quickly come together to find out what roundworm it was and, most importantly, decide on any further treatment the patient might need.

“We just turned to textbooks to find all the different kinds of roundworms that can cause neurological invasion and disease,” says Dr. Senanayake. Their search proved fruitless, and they turned to outside experts for help.

“Canberra is a small place, so we sent the worm, which was still alive, straight to the lab of a CSIRO scientist who has a lot of experience with parasites,” says Senanayake. “He just looked at it and said, ‘Oh my god, it’s Ophidascaris robertsi.'”

Ophidascaris robertsi is a roundworm commonly found in pythons, explains The Guardian. And this is the first case in the world of detection of this parasite in humans.

The patient lives near a lake where carpet pythons live. According to Dr. Senanayake, despite not having direct contact with snakes, she often collected local herbs to use in her cooking.

Doctors hypothesize that the python may have dumped the parasite in its feces into the grass. They believe that the patient probably contracted the parasite directly from touching the local herb or from eating the greens.

Senanayake said the patient needed to be treated for other larvae that may have invaded other parts of her body, such as her liver. But given that no patient had previously been treated for such a parasite, caution was exercised. For example, some medications can cause inflammation as the larvae die off. Inflammation can be detrimental to organs such as the brain, so additional drugs had to be administered to counteract any dangerous side effects.

“This poor patient, she turned out to be so courageous and wonderful,” Senanayake said. “You don’t want to be the first patient in the world with a python roundworm, and we really take our hats off to her.”

According to Senanayake, the patient is recovering well and is still under regular follow-up. Researchers are investigating whether a pre-existing disease that left her immune compromised could have led to larval development taking root. This case was documented in the September issue of Emerging Infectious Diseases.

According to the U.S. Centers for Disease Control and Prevention, three-quarters of new or emerging infectious diseases in humans come from animals, writes The Guardian.

This world-first case has highlighted the dangers of animal-to-human transmission of diseases and infections, Dr. Senanayake said, especially as people and animals begin to live closer together and habitats overlap more and more. “Over the past 30 years, there have been about 30 new infections worldwide,” he says. – Of the emerging infections worldwide, about 75% are zoonotic, which means that the infection is transmitted from the animal world to humans. This includes coronaviruses. This Ophidascaris infection is not transmitted from person to person, so a case with this patient would not cause a pandemic like Covid-19 or Ebola. However, the snake and the parasite are also found in other parts of the world, so it is likely that other cases will be identified in other countries in the coming years.”

Infectious disease doctor Professor Peter Collignon, who was not involved in the patient’s treatment, says some cases of zoonotic diseases may never be diagnosed if they are rare and doctors don’t know what to look for. “Sometimes people die and the cause is never found,” he said. “Be careful when encountering animals and the environment, wash food thoroughly and prepare food properly, and wear protective clothing such as long sleeves.”