8-Centimeter Live Parasitic Roundworm Found in Australian Woman’s Brain Who Complained About Forgetfulness, Depression

A woman who complained of depression and forgetfulness had a live parasitic worm in her brain. The roundworm was reportedly normally found in pythons.

Woman With Live Roundworm in Her Brain

A 64-year-old Australian woman from New South Wales was admitted to a nearby hospital in late January 2021 after experiencing abdominal pain, diarrhea, a dry cough, and night sweats for several weeks.

Her symptoms expanded to depression and forgetfulness by 2022, which led to a referral to Canberra Hospital. Her brain underwent an MRI scan, which revealed anomalies that required surgery.

Dr. Hari Priya Bandi, a neurosurgeon, was shocked to discover an 8-centimeter-long live worm in the patient's brain during diarrhea and took it out.

To determine whether the patient needed any more treatment, a team at the hospital worked to identify the roundworm.

Dr. Sanjaya Senanayake, a Canberra hospital infectious diseases physician colleague, was informed of the unusual discovery by Bandi. Senanayake said the neurosurgeon didn't enter the room expecting to encounter a writhing worm. Although neurosurgeons frequently treat brain infections, the incident was reportedly a once-in-a-career discovery, as nobody anticipated discovering that.

A team at the hospital rapidly came together in response to the unexpected finding to determine what sort of roundworm it was and, more crucially, to determine whether the patient would need any additional treatment.

Senanayake said they checked the textbooks to identify what type of roundworm it was to cause neurological invasion and disease. After failing to find anything, they sought assistance from other experts.

Canberra is a tiny city, so Senanayake had to immediately transfer the worm, which was still alive, to the lab of a CSIRO researcher with a lot of experience with parasites. The specialists were shocked and said it was an "Ophidascaris robertsi," a roundworm typically found in pythons.

What Is Ophidascaris robertsi?

Ophidascaris species are nematodes with an indirect lifespan. The Old and New Worlds are the clear hosts for numerous snakes. O. Robertsi nematodes are indigenous to Australia, and carpet pythons (Morelia spilota) are their main hosts. The python's esophagus and stomach are home to adult nematodes, which lay their eggs in its excrement. Different small mammals consume eggs; larvae develop and act as intermediary hosts.

Third-stage larvae may reach a significant length (7-8 cm), even in small hosts, when they migrate to the thoracic and abdominal organs. When pythons ingest the infected intermediate hosts, their lifecycle ends.

Human infection with any Ophidascaris species has not yet been documented, and humans are considered accidental hosts. The recent case of human neural larva migrans caused by O. robertsi infection is the first in science.

The patient lives close to a lake where carpet pythons live. Despite having no direct encounters with snakes, she frequently picked local grasses from the area of the lake, particularly warrigal greens, for cooking.

The treating physicians think a python may have released the parasite into the grass via feces, infecting the patient who likely handled the native grass or consumed the greens.

The patient was then treated for any larvae that may have spread to other areas of her body, such as the liver, and is recovering fully while still being closely watched.

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