Doctors at an Australian hospital found tapeworm larvae in the brain of a 25-year-old woman who claimed to have been suffering from a week-long headache.
The condition, known as neurocysticercosis, occurs when a person accidentally ingests the eggs of Taenia solium, or “pork tapeworm”, while eating contaminated food. Tapeworm larvae hatch in the gut and are transported via the bloodstream to other organs around the body, including the brain, where they develop into cysts.
While tapeworms are the most common parasitic disease in developing countries, and not uncommon among migrant communities in places like the United States, the 25-year-old—who had never traveled overseas—is the first native case in Australia, according to a recent study in The American Journal of Tropical Medicine and Hygiene.
The woman, who lived in Melbourne, had experienced intermittent headaches and temporary visual symptoms since at least the age of 18, but her symptoms were previously diagnosed as migraines. When she presented with a particularly persistent ache and intense visual symptoms, including blurring of her central vision, doctors at Royal Melbourne Hospital elected to perform an MRI of her brain.
What they found was an eight-millimetre lesion that they originally believed to be an abscess or a tumour. But after operating and removing the cystic mass, they discovered that it “was not human tissue”—and it was, in fact, full of larval tapeworms.
Because the woman’s case involved a solitary lesion that was surgically removed, no further treatment was recommended. But it remains unclear how exactly the woman ingested the tapeworm eggs in the first place.
The 25-year-old lived with her parents and siblings in a metropolitan suburb of Melbourne, worked as a barista in a local cafe, had reportedly never smoked or used any illicit drugs and had no exposure to animals other than pet dogs and cats. She was considered to be at no or very low risk of infection with tapeworm larvae, and researchers could not identify a clear epidemiological link to the source of the disease.
“The patient’s work as a barista did entail ongoing casual contact with people from a variety of geographical regions, but this was not distinguishable from countless other young Australians employed in the hospitality industry,” they noted. “However, it is not surprising that with the high frequency and ease of travel between endemic and non-endemic regions, sporadic infection can occur in people who would otherwise be considered at no or very low risk.”
The study’s authors thus concluded that “Although this case is the first documented of Australian locally acquired [neurocysticercosis], it is possible that more cases could ensue.
“Clinicians need to be mindful that with the ease and frequency of world travel, diseases such as [neurocysticercosis] that are highly endemic in many parts of the world pose a risk to inhabitants of countries with low endemicity,” they said.
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