The patient: A 52-year-old man in the United States
The symptoms: The patient reported to an outpatient clinic after noticing a change in his typical migraine symptoms. Over the previous four months, medications were no longer effective in treating his migraines, and they started occurring more frequently than usual — about once a week — while also becoming more severe. He also reported worsening pain across the back of his skull.
What happened next: Doctors took the man’s vital signs, which were not out of the ordinary. They also took a CT scan of his brain, which revealed numerous cyst-like lesions scattered throughout both hemispheres. Specifically, these growths appeared in the organ’s white matter, the insulated wiring that extends off brain cells.
The patient was immediately admitted to the hospital for a neurosurgical consultation. An MRI backed up what was seen on the CT scan, but it also revealed a buildup of fluid around the cysts in the man’s brain.
The diagnosis: Suspecting a possible parasitic infection, the neurosurgery department sent the patient to infectious disease specialists, who ran a number of tests. One test showed that the man’s blood carried antibodies against Taenia solium, a tapeworm typically found in pigs — lodging in their intestines and muscles and passing in their feces. In the man’s case, the worm’s larvae had invaded his brain and were embedded within cysts inside the tissue. When T. solium infects the nervous system in this way, the condition is known as neurocysticercosis.
The treatment: The patient received antiparasitic and anti-inflammatory drugs while being monitored in the intensive care unit for several weeks, after which he was seen at an infectious disease outpatient clinic. “The patient was successfully treated, with regression of lesions and improvement of headaches,” his doctors wrote in a report of the case.
What makes the case unique: Humans can be infected by T. solium when they inadvertently consume the worm’s larvae or eggs. People can end up being exposed if they eat undercooked pork, for instance, or if they drink water contaminated with the feces of infected pigs or touch their faces or food after touching pig poop.
Consuming undercooked pork containing the larvae can cause an intestinal infection called taeniasis, while consuming feces containing the eggs triggers infections in other tissues, including…
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