Fish is fresh and delicious, but having a worm in your brain is really painful

Ms. Wang, who is only 40 years old, has been a little annoyed recently. She had no history of epilepsy, but she has had frequent limb convulsions recently. In order to find out the cause, she went to the hospital for an examination. The examination scared her. She found that there was something growing in her head...

Combined with the blood test, the doctor highly suspected that Ms. Wang was infected with a parasitic disease. Ms. Wang usually liked to eat sashimi, frog meat, eel and other aquatic products. In pursuit of a taste of freshness, she often feasted on half-cooked meat. She just didn't expect that she would be infected with "worms" this time.

Ms. Wang followed the doctor's advice and underwent surgery, which went smoothly under general anesthesia. According to imaging, the worm was close to the precentral gyrus. Through precise positioning, the surgeon cut a bone window of about 3x3cm in the skull and carefully separated the tissue under a microscope to reduce traction and avoid damage to the motor function area of ​​the posterior precentral gyrus. Finally, a cystic lesion encapsulating the worm was found. The removed cyst was about 0.3x0.4cm, and a parasite that was still wriggling was captured after the cyst was cut open. From the morphology of the worm, it is considered possible to be a sparganosis, and deworming treatment will be performed after the pathology is confirmed. Ms. Wang recovered quickly after the operation. After observation, no neurological symptoms appeared, and she has now recovered and been discharged from the hospital.

Sparganum is a flatworm of the genus Diplodocerca of the family Sparganum in the order Pseudophyllodes. It is highly infectious. It often parasitizes in frogs and snakes. When people eat water or food containing worm eggs, the eggs can be attached to the intestinal wall, then hatch into larvae, and then break through the blood-brain barrier and enter the brain through the blood circulation. Sparganum living or breeding in various parts of the body can cause corresponding symptoms such as ocular sparganosis and subcutaneous sparganosis, which manifest as small nodules under the skin, local redness, swelling, pain, and a crawling sensation. When sparganum parasitizes in the brain, the enlarged cyst may compress the intracranial tissues, causing symptoms such as headaches, projectile vomiting, and epilepsy. In this case, Ms. Wang had a clear history of eating raw aquatic products and symptoms of intracranial mass.

Eating raw aquatic products is a high-risk factor for parasitic infection. In addition to the above-mentioned sparganosis, there are many other parasites that parasitize the human body, such as tapeworms and trematodes. Cases of parasitic diseases caused by eating raw food are not uncommon. Since some parasite eggs will be killed by hypertonic saline, many people think that deep-sea fish have a low risk of parasitic infection. In fact, marine fish also have parasites. For example, Anisakis is a parasite of the family Anisakidae in the order Ascaris that mainly parasitizes marine animals. Some common edible marine fish will be infected with Anisakis. Once people eat uncooked marine fish products such as sushi, sashimi, etc., they may be infected with Anisakiasis. Therefore, scientifically handling food ingredients is an important step in avoiding parasitic infections.

Cooking is the simplest and most effective method. According to research, most parasites cannot tolerate high temperatures. Heating to above 60° for several minutes can kill most parasites, greatly reducing the chance of parasite infection. At the same time, it is also important to avoid cross-contact between raw and cooked food. Kitchen utensils that come into contact with raw meat should be kept away from cooked food. There have been many reports of cross-infection with liver flukes due to the use of kitchen utensils that are not distinguished between raw and cooked. Therefore, in daily life, it is necessary to strictly distinguish between raw and cooked food utensils, and separate knives and cutting boards used to handle raw and cooked food to reduce the risk of parasitic infection.

Warm reminder: remember that the mouth is the source of trouble, "fresh" and "dangerous" coexist! Do not get sick because of greed for the momentary desire of the mouth. If you are unfortunately infected with parasites, you still need to go to a regular hospital for treatment under the advice of a professional doctor.

Hu Rui, Department of Anesthesiology, Guilin Medical College Hospital

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