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In a story recently published on CNN, an 18-year-old who complained of seizures in the emergency room of an Indian hospital turned out to have parasites (eggs of intestinal worms were embedded in his brain). Drs. Nishanth Dev and S. Zafar Abbas of the ESIC Medical College and Hospital in Faridabad reported that the patient, who appeared in the ER with swelling over his right eye, was having tonic-clonic seizures. Formerly known as “grand mal” seizures, these neural disturbances cause stiffened muscles and a loss of consciousness.

His parents said that their son had felt pain in his right groin for a week. A physical exam revealed that he had tenderness in the right testis and was feeling confused.

To learn more about his condition, the medical staff performed an MRI exam and saw damage caused by cysts in his cerebral cortex (the outer mantle of brain tissue) as well as the brain stem, including the cerebellum, which sits at the back of the head above the spinal cord.
Diagnosis: neurocysticercosis, a parasitic disease of the brain caused when someone swallows tapeworm eggs that have passed in the feces of someone who has an intestinal tapeworm. The larvae crawl out of the eggs and into muscle and brain tissues, where they form cysts. The doctors also discovered cysts in the patient’s right eye and right testis.
Because of the number and location of the cysts, his doctors decided against treating the young man with antiparasitic medications. These can worsen brain bleeding and inflammation while leading to loss of vision. Instead, the patient was given an anti-inflammatory drug, dexamethasone, plus antiepileptic medications.
Two weeks after his arrival in the ER, the patient died, Dev and Abbas report.
Intestinal worms, or parasitic worms, are simple organisms that feed off the human body. Many people recognize the more common varieties, such as tapeworms and hookworms, but may be less aware of the others.

Intestinal worms can cause many symptoms in the body, some of which are similar to the symptoms of other gut disorders. A quick and thorough diagnosis is crucial in each case to avoid complications.

Doctors may use antiparasitic medications or other treatments to help get rid of the worms. Although intestinal worms may seem scary, most people respond well to treatment.

Symptoms

Each species of intestinal worm may cause different symptoms, and the symptoms may also vary from person to person.

However, some common signs and symptoms of intestinal worms include:

In some cases, the person may start passing segments of the intestinal worm in their stool.

In rarer cases, the intestinal worm may lead to severe blockages in the intestine, making it difficult for the person to have a bowel movement.

Risk factors – intestinal worms

As a 2016 study notes, over 3.5 billion people around the world have an intestinal parasite infection.

The vast majority of these infections occur in developing countries where sanitation is poor. However, intestinal worms are still possible in developed areas.

Some people may be more at risk of contracting an intestinal worm. These people include those with a weakened immune system, such as older people and people living with HIV.

Pregnancy does not increase the risk of getting intestinal worms, but intestinal worms may pose a more significant health risk for people who are pregnant. Some antiparasitic medications may not be safe during pregnancy.

Anyone who is pregnant and has an intestinal worm should work closely with their doctor throughout their treatment.

Diagnosis of intestinal worm infections

Doctors may use a colonoscopy to check the bowel for parasites

Doctors may order several different tests to help them diagnose intestinal worms. These tests may include:

  • fecal tests to check for signs of infection
  • blood tests to detect some types of parasite
  • colonoscopy, which uses a thin camera to check the bowel for parasites
  • imaging tests to check other organs for signs of damage from the parasite
  • tape tests

A tape test involves placing a piece of tape over the anus as the person sleeps to check for signs of eggs.

Anyone who suspects that they have an intestinal worm should see a doctor.

Treatment

Although intestinal worms sound a bit frightening, treatment is often straightforward. In some cases, the person may not need any treatment at all. A healthy immune system may be sufficient to manage some types of tapeworm without the need for medication.

In other cases, doctors will use one or more antiparasitic medications to get rid of the intestinal worm.

Doctors will sometimes choose to monitor the person first to see if their body can take care of the worm before moving on to medication. During this period, the individual should report any symptoms to the doctor.

Some signs and symptoms may indicate that further treatment is necessary. These may include:

  • vomiting
  • high fever that lasts for more than a couple of days
  • extreme fatigue
  • dehydration
  • changes to the color of stool
  • blood in the stool

Before commencing a person’s medical treatment, the doctor has to identify the specific type of intestinal worm. The type of worm will determine the best treatment option.

Doctors often prescribe praziquantel (Biltricide) to clear out a tapeworm. This drug paralyzes the worm, forcing it to detach from the intestinal wall. It then helps dissolve the worm so it can pass through the digestive system and leave the body during a bowel movement.

In the case of hookworms, doctors prescribe anthelmintic drugs, such as mebendazole or albendazole.

Triclabendazole may help treat flukes, while pinworm infections often respond well to both over-the-counter and prescription drugs.

People should never eat under-cooked or raw meat.

While it may not be possible to get rid of all possible sources of intestinal worms, it is still essential to take certain steps to avoid them where possible.

One of the more important aspects of prevention is basic sanitation. For instance, people should always wash their hands both before and after using the toilet to avoid possible exposure. Washing the hands before cooking or handling food is also crucial.

Many intestinal worms enter the body through the food that a person eats. As a result, it is essential to follow some safe food practices:

  • Thoroughly cook pork, beef, and other red meats to an internal temperature of 145°F.
  • Always cook poultry, such as chicken and turkey, to an internal temperature of 165°F.
  • Ensure that cooked fish reaches an internal temperature of 145°F.
  • Never eat undercooked or raw meats.
  • Use separate cutting boards for meats and vegetables.
  • Thoroughly wash and peel all fruits and vegetables.
  • Only use clean water.

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