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Freeman [soylentnews.org] writes:

https://arstechnica.com/health/2025/02/burning-in-womans-legs-turned-out-to-be-slug-parasites-digging-in-her-brain/ [arstechnica.com]

It started with a bizarre burning sensation in her feet. Over the next two days, the searing pain crept up her legs. Any light touch made it worse, and over-the-counter pain medicine offered no relief.

On the third day, the 30-year-old, otherwise healthy woman from New England went to an emergency department. Her exam was normal. Her blood tests and kidney function were normal. The only thing that stood out was a high number of eosinophils [medlineplus.gov]—white blood cells that become active with certain allergic diseases, parasitic infections, or other medical conditions, such as cancer. The woman was discharged and advised to follow up with her primary care doctor.
[...]
At home again, with little relief, a family member gave her a prescription sleep aid to help her get some rest. The next day, she awoke confused, saying she needed to pack for a vacation and couldn't be reasoned with to return to bed.
[...]
In a case report published in the New England Journal of Medicine [nejm.org], doctors explain how they figured out the source of her fiery symptoms—worms burrowing into her brain. By this point, she was alert but disoriented and restless. She couldn't answer questions consistently or follow commands.
[...]
Blood smear tests showed no evidence of parasites, and a computed tomography (CT) scan of her head showed no acute intracranial abnormalities. But, the results of a spinal tap showed a clear problem: her cerebrospinal fluid showed a count of 694 white blood cells per microliter. The reference range was 0 to 5.
[...]
They went through them one by one, crossing things off the list that didn't quite fit with everything they knew of her case. They ended with angiostrongyliasis, caused by the nematode (roundworm) Angiostrongylus cantonensis, also known as rat lungworm [cdc.gov].
[...]
Humans crash this process by accidentally eating the L3 larvae. This can happen if they eat undercooked snails or slugs, or undercooked creatures that eat slugs or snails, such as land crabs, freshwater prawns, or frogs. The more troubling route is eating raw vegetables or fruits that are contaminated by snails or slugs. This is possible because the L3 larvae are present in mollusk slime. For instance, if a slug or snail traverses a leaf of lettuce, leaving a slime trail in its wake, the leaf can be contaminated with the larvae. The authors of the case study note that "the infectious dose of slime is not defined."
[...]
This nauseating roundworm is a known plague in Hawaii. In fact, it gained attention in recent years after sparking small outbreaks in the state [hawaii.gov]. In 2017, there were 19 confirmed cases, but case totals in each of the years since have remained below 10.
[...]
In this case, the patient and her doctors decided to use a 14-day combination of the immunosuppressive steroid prednisone and the anti-parasitic drug albendazole.

Fortunately, the woman's symptoms cleared with the treatment, and she was discharged from the hospital after six days.

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