A woman developed a persistent infection, and doctors couldn't pinpoint the cause for many months.
When you purchase through links on our site, we may earn an affiliate commission. Here’s how it works.
Unlock instant access to exclusive member features.
By submitting your information you agree to the Terms & Conditions and Privacy Policy and are aged 16 or over. You are now subscribed
Once a week Life's Little Mysteries Feed your curiosity with an exclusive mystery every week, solved with science and delivered direct to your inbox before it's seen anywhere else.
Get full access to premium articles, exclusive features and a growing list of member rewards.
The patient: A 64-year-old woman in New South Wales, Australia
The symptoms: The woman was admitted to the hospital after experiencing abdominal pain and diarrhea for three weeks. She also had a persistent dry cough and night sweats.
A CT scan of her lungs showed opaque areas where the tissue had thickened, likely due to inflammation or an infection that caused the air spaces in the lungs to fill with fluid, pus or a buildup of white blood cells. The woman also had lesions, or areas of damaged tissue, in her liver and spleen.
- A woman got a rare parasitic lung infection after eating raw frogs
- Diagnostic dilemma: 83-year-old man's unusual form of syphilis had an 'uncertain' source
- Teenager contracts rare 'welder's anthrax,' marking the ninth known case ever reported
When doctors sampled fluid from the patient's lungs, they found an unusually high percentage of eosinophils, a type of infection-fighting white blood cell. At that time, they diagnosed the woman with a rare lung condition called eosinophilic pneumonia and prescribed a daily dose of the steroid prednisolone, which relieved some of her symptoms. They noted that the cause of the lung infection was unknown.
What happened next: Three weeks later, the woman returned to the hospital with a cough and a fever, despite still taking prednisolone, and the lesions on her organs had not healed.
Further tests failed to identify the cause of her respiratory distress. Tissue sample cultures showed no signs of bacterial or fungal infection. Blood work showed that her immune system wasn't producing antibodies to various parasitic flatworms, such as blood flukes (Schistosoma) or liver flukes (Fasciola). Nor was there any evidence of these parasites in her fecal samples.
Doctors advised the patient to continue taking prednisolone and also prescribed her ivermectin, a treatment for parasitic worms, as she had informed the doctors that she'd traveled to countries where such parasites are common.
Get the world’s most fascinating discoveries delivered straight to your inbox.
But her respiratory symptoms did not go away, and they worsened when she attempted to reduce the prednisolone dosage. Her condition continued unchanged for several months.
The diagnosis: About a year after her initial hospital visit, the woman began to develop signs of depression and had episodes of forgetfulness. Physicians ordered an MRI of her brain and detected a lesion on the right frontal lobe. They then performed an open biopsy to expose and examine the damaged area. That's when they discovered "a stringlike structure" inside the lesion, which they identified as a living parasitic worm called a helminth, according to a report of her case.
The worm was bright red and measured about 3 inches (80 millimeters) long and 0.04 inches (1 millimeter) thick.
- Diagnostic dilemma: 83-year-old man's unusual form of syphilis had an 'uncertain' source
- Teenager contracts rare 'welder's anthrax,' marking the ninth known case ever reported
- Man caught rabies from organ transplant after donor was scratched by skunk
The treatment: Doctors removed the helminth from the woman's frontal lobe and examined the surrounding tissue, where they found no more parasites. They gave her ivermectin for two days, this time in combination with a four-week course of albendazole, a broad-spectrum drug for treating helminth infections, to kill any lingering parasites in her organs.
Albendazole is absorbed by the central nervous system more quickly than ivermectin is, and these drugs have previously been used together to treat nematode infections in humans and snakes. The patient also received a 10-week course of the corticosteroid dexamethasone, to prevent additional inflammation.
Six months after the surgery and three months after the end of the dexamethasone course, the lesions in the patient's lungs and liver were gone, her white blood cell count was normal, and her neuropsychiatric symptoms had improved.
—Woman had her twin brother's XY chromosomes — but only in her blood
—Giant 'stone' in a man's bladder looked like an ostrich egg
—A woman got a rare parasitic lung infection after eating raw frogs
