Woman's Severe Burning Sensation in Feet Diagnosed As Parasitic Worms in the Brain; Know All About Rat Lungworm Disease

A 30-year-old woman who just returned from her trip to Thailand, Japan, and Hawaii complained of a burning sensation in her feet. When the unusual set of symptoms did not get over, she sought medical help, only to be diagnosed with parasitic worms in her brain.

For the travel enthusiast, her symptoms began with experiencing a lot of fatigue, which is brushed off as jet lag, but slowly they graduated to recurrent headaches and a severe burning sensation in her feet. According to the American woman, the sensation, which was earlier restricted only to the soles of her feet, slowly travelled up to her legs and "worsened with a light touch." Thereafter, she was admitted to the hospital for further investigations.

She was then detected with angiostrongyliasis, a parasitic infection caused by the roundworm Angiostrongylus cantonensis, also commonly known as rat lungworm. According to doctors, most people get mild or no symptoms, but the parasite can infect your brain and cause headaches, neck stiffness, vomiting, and brain and nerve issues.

This case of the woman, published in the New England Journal of Medicine, talks about how her swimming in the sea in Hawaii several times and eating raw food and fish could have led to the infection and parasites in her body.

According to Dr. Joseph Zunt, a neurologist and infectious specialist who is also one of the authors of the study, the rat lungworm parasite is "endemic" in Hawaii and easily acquired. "Infection can be acquired through multiple sources: ingestion of raw or undercooked infected snails or slugs; ingestion of vegetables or fruits contaminated by infected snails, slugs, or flatworms or by slime from snails or slugs that contains infectious larvae; or ingestion of infected paratenic hosts (e.g., land crabs, freshwater prawns, or frogs) that have consumed an infected snail," he said.

According to Dr. Zunt, snails and slugs pick up the infection from the faeces of infected rats, who may also contract it from eating an infected snail. Rats also vomit the eggs from their lungs and then eat them—the journal notes it's a "complicated life cycle."

Experts say rat lungworm is a parasitic worm that usually lives in the pulmonary artery—the reason it was given this name. Most people who get an infection do not have any symptoms, but sometimes the worm travels to your brain and causes eosinophilic meningitis.

Rat lungworm infections are also known as angiostrongyliasis.

According to doctors, the symptoms of eosinophilic meningitis caused by rat lungworm include:

• Severe headache
• Neck pain or stiffness that eventually becomes so severe that you may not be able to move your chin down toward your chest
• Nausea and vomiting
• Tingling or pins-and-needles feeling
• Changes in your vision
• Confusion
• Sensitivity to light

What are the complications caused by rat lungworm?

Doctors say most people with rat lungworm make a full recovery. However, in a few rare cases, those who have eosinophilic meningitis can have complications and long-term health effects, which include:

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