Inside today strange patientthe challenge of a teenager who runs very badly.
The challenges teenagers set to test their mettle sometimes have dramatic consequences. In Australia, a teenager accepts a nasty challenge from his friends: eat two snails they’ve found in his Sydney garden. Flea! The young man runs but will regret it bitterly.
A few days later, he starts feeling sick. She contracts a violent gastrointestinal attack that lasts a week but eventually recovers. Three weeks later, she feels nauseous, vomits repeatedly, and suffers from stiff neck and intolerance to bright lights. With her parents he goes to the hospital to find out what’s wrong. Upon auscultation, doctors identify low-grade fever and signs of meningitis, but a brain scan shows no problems.
On the other hand, the blood test is more of a concern. He has an eosinophil count well above normal; monocytes are also present in large quantities in your cerebrospinal fluid. Eosinophilia is usually associated with a parasitic infection or an allergy. Doctors test for two species of parasitic worms common in Australia: Strongyloidsand angiostrongyl. The results are negative. After 12 days in the hospital she goes home; his meningitis was considered cured.
A severe parasitic worm infection of the rat
Only his condition suddenly deteriorates five days later, forcing his family to return to the hospital. He was hospitalized in a worrying state: irritable, drowsy, eye papilledema testifying to excessive pressure on the skull and numb hands. His blood tests reveal eosinophilia three times more severe than when he was first hospitalized. This time, the brain scan shows multiple lesions in the white matter. The doctors interrogate the young patient who ends up admitting that he had eaten two snails five weeks earlier. The presence of the parasite is finally confirmed.
The two molluscs were two leopard snails (maximum lemax)one of the intermediate guests of Angiostrongylus cantonensis, a several centimeters long parasitic worm that normally infects the lungs of rats. Humans are accidental hosts of the worm, which becomes infected by eating raw or undercooked shellfish or vegetables contaminated by the larvae. These reach the adult stage after two to three weeks and cause what doctors call eosinophilic meningoencephalitis.
Sometimes fatal cases
The teenager was hospitalized for 17 days and took more than five months to recover from the infection before returning to normal daily life. This case described in 2003 it is the first case of acquired human angiostrongyliasis, but not the last.
In 2010, a young Australian faced the same challenge: eating snails. Even the shellfish were contaminated angiostrongyl which put him in a coma for 420 days and left him paralyzed from head to neck for eight years. He finally died in 2018.
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