Angiostrongyliasis in Humans: A Case Report Overview
In a world where travel often exposes us to new cultures and cuisines, the health risks associated with exotic foods can sometimes lurk unnoticed. This was the unsettling reality for a 30-year-old woman from New England, who experienced an alarming medical mystery that began with an unusual burning sensation in her feet. Over the course of a week, her condition escalated, leading her through multiple emergency departments and a series of baffling examinations. As her symptoms intensified, so did the search for answers, ultimately revealing the shocking presence of a parasitic infection that would challenge both her health and the expertise of medical professionals.
| Category | Details |
|---|---|
| Initial Symptoms | Bizarre burning sensation in feet, advancing pain in legs, light touch worsened pain. |
| Emergency Visits | Visited emergency department three times due to worsening symptoms. |
| Medical Findings (First Visit) | Normal exam and blood tests, high eosinophils (1,050) detected. |
| Travel History | Recently traveled to Bangkok, Tokyo, and Hawaii. |
| Key Symptoms (Second Visit) | Scorching sensation spread to trunk and arms, severe headache. |
| Cerebrospinal Fluid Analysis | 694 white blood cells per microliter (normal range 0-5). |
| Final Diagnosis | Central nervous system angiostrongyliasis due to Angiostrongylus cantonensis. |
| Infection Source | Ingested L3 larvae from contaminated food (raw seafood/salads). |
| Treatment | 14-day treatment with prednisone and albendazole. |
| Outcome | Symptoms cleared, discharged after six days. |
The Mysterious Symptoms Begin
It all started with an odd burning sensation in the woman’s feet. This strange feeling quickly turned into a painful experience that spread up her legs. She could hardly bear the lightest touch, and no amount of over-the-counter pain medicine seemed to help. Knowing something was wrong, she decided to visit the emergency department to find out what was causing her discomfort.
At the hospital, doctors examined her thoroughly. They checked her blood and even her kidney function, but everything appeared normal. The only unusual finding was a high eosinophil count, which can signal allergies or infections. After not finding a clear answer, the doctors sent her home, suggesting she follow up with her primary care doctor. Little did they know, her health was about to take a shocking turn.
Escalating Pain and Confusion
As days passed, the woman’s pain worsened and spread to her arms and trunk. She started to develop a severe headache that did not respond to any pain relief medication. After a week of suffering, she returned to the emergency department, where doctors again found normal test results but noted her eosinophil count had increased significantly. Determined to help her, they provided intravenous medication for her headache.
Despite the treatment, she went home with no real answers. Soon after, a family member gave her a sleep aid to help her rest. However, when she woke up, she was confused and unable to think clearly. Frustrated and worried, her partner took her to a third emergency department, where specialists began to piece together the mystery of her alarming symptoms.
The Search for Answers
At Massachusetts General Hospital, doctors were perplexed but focused on the woman’s recent travels. Just before her illness began, she had visited countries known for their delicious yet sometimes risky street food. The doctors asked her about her meals, hoping to find a clue that would explain her strange symptoms.
The medical team quickly suspected an infection, likely caused by a parasite. They carefully reviewed her eating habits during her trip, especially her sushi consumption. Despite tests showing no parasites in her blood, a spinal tap revealed alarming signs of infection. The pressure was on to identify the culprit behind her fiery pain and confusion.
Understanding the Parasite’s Life Cycle
The doctors soon discovered that the infection was caused by a nematode known as Angiostrongylus cantonensis, which is also called rat lungworm. This parasite has a complex life cycle that involves rats, snails, and slugs. The cycle starts when rats excrete the worm larvae, which then infect slugs or snails. When humans accidentally consume these infected creatures, they can become serious sick.
Once ingested, the larvae migrate through the human body, often reaching the brain. This is what caused the woman’s unusual symptoms, like the burning sensation in her feet. Understanding this life cycle was crucial for the doctors, as it helped explain how the woman became infected and what was happening inside her body.
Diagnosing the Infection
After a thorough examination and testing, the doctors were able to diagnose her condition as central nervous system angiostrongyliasis. This diagnosis was made after they confirmed the presence of the parasite’s DNA in her cerebrospinal fluid. This was an important breakthrough, as it allowed the medical team to understand exactly what they were dealing with.
The identification of the parasite was a relief, but it also raised concerns. There are no standard treatments for this type of infection, and the recovery might take time. The doctors decided on a combination therapy of steroids and anti-parasitic medication to help the woman recover from her symptoms.
The Road to Recovery
Fortunately, after starting the treatment, the woman began to feel better. The combination of medications helped to reduce her symptoms significantly. It was a long journey, but her determination and the efforts of her medical team led to a positive outcome.
After six days in the hospital, she was finally discharged, much to the relief of her family and friends. Her experience serves as a reminder of the importance of seeking medical help when faced with unusual symptoms and highlights the fascinating yet complicated world of parasites.
Frequently Asked Questions
What caused the woman’s burning sensation in her feet?
The burning sensation was caused by Angiostrongylus cantonensis, a parasitic roundworm that infected her central nervous system after she consumed contaminated food during her travels.
What are eosinophils and why were they significant in this case?
Eosinophils are white blood cells involved in allergic reactions and infections. The woman’s high eosinophil count indicated an unusual medical condition, prompting further investigation into potential infections.
How did the doctors diagnose her condition?
Doctors diagnosed her condition through a combination of her symptoms, travel history, and tests such as a spinal tap, which revealed abnormal white blood cell counts in her cerebrospinal fluid.
What is Angiostrongylus cantonensis?
Angiostrongylus cantonensis, also known as rat lungworm, is a parasitic roundworm that can infect humans through contaminated food, leading to neurological symptoms.
What symptoms did the woman experience during her illness?
The woman experienced burning pain in her feet, headaches, confusion, and disorientation, which worsened over several days before she sought medical help.
What treatment did the woman receive for her condition?
She was treated with a combination of the immunosuppressive steroid prednisone and the anti-parasitic drug albendazole, which helped clear her symptoms.
Can Angiostrongylus cantonensis be fatal?
While infections can be serious and lead to neurological issues, many people recover fully without treatment. Severe cases can be life-threatening but are rare.
Summary
A 30-year-old woman experienced a strange burning sensation in her feet, which spread to her legs and caused severe headaches. Despite normal test results, doctors noticed a high eosinophil count, indicating a possible infection. After several visits to emergency rooms and ongoing symptoms, specialists at Massachusetts General Hospital suspected a parasitic infection linked to her recent travels. They identified the culprit as Angiostrongylus cantonensis, a roundworm that can invade the brain. Treatment with medication helped her recover, allowing her to leave the hospital after six days.