Doctor Curmudgeon® Blech!!!
By Diane Batshaw Eisman, M.D. FAAP Doctor Eisman is in Family Practice in Aventura, Florida with her partner, Dr. Eugene Eisman, an internist/cardiologist
Nobody likes me.
Everybody hates me.
I’m going to eat some worms.
Nice big fat ones.
Little ushy gooshy ones….
And the little ditty does go further. To spare the sensitivity of my readers I won’t repeat more of this refrain.
However, it has infiltrated my brain due to the suffering of a poor Australian woman.
This unsuspecting woman had been ill for several weeks. Her complaints were many. She had night sweats, fever, and painful spasms in her stomach. This was enough to make her life miserable. But she also had a dry cough and diarrhea.
Her white blood count was elevated but there were no signs of an infection. The patient suffered for a year and a half. All this time, her physicians grappled with her symptoms in search of a diagnosis and treatment. Scans showed lesions in her spleen, liver and lungs along with this high white count.
And then things got worse. She had depression and difficulties with her memory. Of course, with all that physical agony, who wouldn’t be depressed and have trouble thinking?
An MRI of her brain was done. There were abnormalities on the scan and it was thought to be a tumor. Biopsies came next.
The woman’s physicians were dumbfounded. The woman was horrified.
The neurosurgeon who did the biopsy, Dr. Hari Priya Bandi, said, “We don’t find things that are surprising and when we do, that’s just unheard of.”
Dr. Bandi placed a call to neurosurgeon, Dr. Sanjaya Senanayake, an infectious disease specialist.
She said to him, “Oh my god you wouldn’t believe what I just found in this lady’s brain- and it’s alive and wriggling.”
Dr. Bandi had just removed an 8 cm long roundworm.
The story becomes more bizarre as it turns out that the worm is most commonly found in pythons. It’s called Ophidascaris robertsi.The life cycle of this worm does not include living inside of a human being, and certainly not within the brain. How could it jump from a python to a person?
Now this hospital in Canberra can lay claim to a first. This is the first time this specific parasite has wormed its way into a human.
That nasty little thing had most likely worked its way through her liver and her lungs to set up residence in her brain.
This was not just an unusual case, but an extraordinarily difficult one. Dr. Senanayake, the infectious disease expert, said that the patient had to be treated for other kinds of larvae also; because nobody knew what additional larvae might have penetrated her body.
The physicians were careful and the patient did recover. As she was the first, nobody had been treated before for this specific parasite. And then there was concern that, as the larvae were killed, a horrendous inflammation could be set off in the patient.
But, how on earth, did the patient meet this worm?
It seems that she frequently gathered the dirty grasses around her home to use in her food preparation. It is possible that somehow the eggs of the worm were transferred to her in that way. When she ingested the eggs, the worms probably made a home in her stomach, and then traveled onward and upward.
Daniel Wu writes in The Washington Post, “”…the roundworm’s
Survival in the woman’s body may have been aided by the immunosuppressants she was prescribed to treat her high white blood cell levels.”
Australian researchers are studying how the larvae was able to invade and prosper in her body
I repeat, “Blech!”
Even that courageous neurosurgeon, Dr. Bandi said, according to Australia’s channel 7 news, “There was a moment for me for just feeling a bit nauseated.”
Dr. Curmudgeon suggests “Bitter Medicine”, Dr. Eugene Eisman’s story of his experiences–from the humorous to the intense—as a young army doctor serving in the Vietnam War.
Bitter Medicine by Eugene H. Eisman, M.D. –on Amazon
Doctor Curmudgeon® is Diane Batshaw Eisman, M.D., a physician-satirist. This column originally appeared on SERMO, the leading global social network for doctors.
SERMO www.sermo.com
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