In a bizarre incident, a woman reported a painful burning sensation in a woman’s legs and when she consulted doctors she got the shock of her life. The case was published in The New England Journal of Medicine recently.
According to a report by Live Science, the woman’s symptoms began with a strange burning sensation in her feet. Over the coming days, the pain spread up her legs, and the impacted areas became sensitive to even the lightest touch. She was also fatigued, but she initially attributed that to jet lag following a three-week trip to Thailand, Japan and Hawaii.
She went to an emergency department about the sensations in her legs, but her exams came back normal and she was ultimately discharged. Reportedly, after couple of days the sensations spread to her truck and arms and she developed a headache. So she went to a second emergency department, and again, her exams were “reportedly normal,” although her immune-cell count was up. She received medications that relieved her headache before being discharged, Live Science reported.
Soon the woman developed confusion and her partner brought her to hospital once again. Her blood tests and kidney function were still normal, and microscopic examination of her blood showed no obvious signs of parasites. However, one thing that did stand out was an elevated level of a type of white blood cell called eosinophils; these cells help the body fight off foreign invaders, including parasites.
The medical team then performed a lumbar puncture, or spinal tap, to draw out a sample of cerebrospinal fluid. Reportedly, this test also revealed a very high level of eosinophils. Her results were consistent with a condition known as eosinophilic meningitis, a rare form of inflammation in the brain and spinal cord often caused by parasites.
According to the case report, the most common cause of eosinophilic meningitis is rat lungworm (Angiostrongylus cantonensis), a parasite that lives in many tropical and subtropical regions in Southeast Asia and the Pacific Islands, including Hawaii.
After ruling out other culprits, the team determined A. cantonensis was behind the woman’s case. While the parasite was not detected in the patient’s blood, further testing of her cerebrospinal fluid revealed genetic traces of the parasite.
Once in the human brain, the parasite can trigger headaches, a stiff neck, vomiting, confusion, tingling or burning sensations and eventually, seizures and vision problems. According to the Centers for Disease Control and Prevention (CDC), in many cases, A. cantonensis infections resolve on their own as the parasites die off, even in cases of meningitis. In those cases, supportive treatments might include painkillers and antiinflammatories. That said, these infections can sometimes be fatal.
However, in this woman’s case, the patient was given a 14-day course of antiparasitic medication, together with a steroid drug to help bring down inflammation in her nervous system. She was discharged from hospital after six days.
To prevent infection with rat lungworms like A. cantonensis , the CDC recommends that people not eat raw or undercooked snails or slugs, frogs, shrimp or prawns. They should wear gloves and wash hands after handling snails or slugs in the garden. The agency also adds that people should always wash fresh produce thoroughly and avoid eating uncooked vegetables in areas where the parasite is endemic, Live Science reported.