Mysterious Burning Feet Traced to Worms in the Brain: A Doctor’s Account

Woman’s Mysterious Burning Feet Traced to Worms in Her Brain: A Doctor’s Case Study

A 30-year-old woman from the United States sought medical help after experiencing a mysterious burning sensation in her feet. Little did she know, the cause of her discomfort would be linked to parasites that had unwittingly made their way into her brain. The parasitic infection was traced back to her travels in Thailand, Japan, and Hawaii, where she had unknowingly picked up worms that had since embedded themselves in her central nervous system. What followed was a challenging journey of diagnosis, pain, and ultimately, treatment.

The Mysterious Symptoms Begin

The woman’s symptoms initially appeared to be relatively benign, starting with a burning sensation in her feet. However, these symptoms gradually worsened over the course of several days. Within two weeks of returning home from her travels, the discomfort began to spread from her feet, up her legs, and into her trunk and arms. The sensation eventually culminated in a severe, persistent headache that no pain relief seemed to alleviate.

Her first visit to the emergency department resulted in a mild increase in white blood cell count, suggesting some form of infection or inflammation, but nothing immediately alarming showed up in her blood tests or scans. Despite initial reassurance, the woman’s condition worsened. Her fever persisted, and the burning pain continued to spread. After several days of no improvement, she sought care at another hospital, desperate for answers.

The Search for a Diagnosis

The woman’s headache was finally managed after a combination of intravenous anti-inflammatory treatment and lorazepam, a medication often used to manage anxiety. Although her headache subsided, the strange symptoms continued. The next day, her behavior became increasingly erratic. She began packing for a vacation she had not planned, displaying signs of confusion and disorientation. Concerned, her partner took her back to the hospital.

Given the combination of sensory symptoms, persistent headache, and the emerging confusion, medical professionals suspected encephalitis, a brain inflammation that often signals a central nervous system infection. While initial tests did not reveal any parasites in her blood or any immediate issues on a CT scan, a lumbar puncture—a procedure that collects cerebrospinal fluid (CSF) from the spine—provided a key clue.

The Diagnosis: Angiostrongyliasis

Testing the CSF revealed markers consistent with eosinophilic meningitis, a rare form of brain infection that can be caused by parasites. Based on her symptoms and recent travel history, the woman was diagnosed with angiostrongyliasis, a parasitic disease caused by the worm Angiostrongylus cantonensis, also known as rat lungworm.

This parasite’s lifecycle begins in the lungs of rats, which release larvae into the environment through their feces. The larvae then move to snails and slugs, where they become infectious. Humans typically ingest the larvae by consuming contaminated food—particularly underwashed leafy greens or undercooked seafood like crabs and prawns, which feed on these snails and slugs.

Although rat lungworm infection is relatively rare in many parts of the world, it is known to occur in tropical and subtropical regions, including Southeast Asia, the Pacific Islands, and Australia. The woman had unknowingly consumed contaminated food during her travels in Thailand, Japan, and Hawaii, and the larvae found their way into her body. From there, they traveled to her central nervous system, where they caused inflammation and the severe symptoms that brought her to the hospital.

Treatment and Recovery

Fortunately, the woman’s diagnosis was caught in time. To treat the parasitic infection, doctors administered a two-week course of medication capable of crossing the blood-brain barrier. This treatment was essential for targeting the parasites in the brain and preventing further neurological damage. In addition to the anti-parasitic drugs, the woman was given prednisone, a corticosteroid that helped reduce inflammation in her brain.

Within days of starting treatment, the woman’s symptoms began to improve. The burning sensation in her feet subsided, her headache lessened, and her confusion cleared. On the sixth day of her hospital stay, she was discharged, free from the parasites that had caused such distress and discomfort.

The Importance of Preventative Measures

This case highlights the importance of vigilance when traveling to areas where diseases like angiostrongyliasis are prevalent. Simple steps, such as thoroughly washing vegetables and ensuring that seafood is cooked properly, can reduce the risk of parasitic infections. Travelers should also be aware of the risks associated with consuming raw or undercooked food, especially in regions where these parasites are known to exist.

Conclusion

While the woman’s experience was undoubtedly terrifying, it also serves as a reminder of the complex and sometimes elusive nature of parasitic infections. Diseases like angiostrongyliasis can present with a wide range of symptoms, many of which can be mistaken for more common illnesses. Early diagnosis and appropriate treatment are crucial for preventing serious complications, such as irreversible neurological damage. By understanding the symptoms and causes of these infections, both patients and healthcare providers can be better prepared to identify and treat them swiftly.