A woman ate crayfish (also known as crawfish) with worms burrowed into it and subsequently suffered an adverse medical reaction.
According to a report published in the Journal of the American Medical Association, the 60-year-old woman arrived at the hospital following three days of “persistent fever,” which had raised to 38 degrees Celsius or 100.4 degrees Fahrenheit. At the time of her arrival, she couldn’t communicate normally. Prior to the incident, she was described as healthy, per the report.
After determining her limbs’ muscular function, tone and reflexes were normal — despite the patient exhibiting a stiffness in her neck — an MRI scan showed “multiple white matter lesions” in the brain. She was initially diagnosed with purulent meningitis, and though she was treated with medicine meant to reduce her fever and treat infection, her symptoms showed no improvement.
Doctors facilitated another MRI, this time with contrast, and found the white matter in her brain significantly increased over the two weeks. They also conducted a blood test which showed a higher-than-normal level of eosinophils — which sometimes indicates a parasitic infection, according to the study.
From a conversation with the woman’s family, doctors discovered the patient had “consumed a substantial amount of leftover crayfish the night before onset of fever.” This led physicians to conclude that the woman’s white matter damage in her brain was caused by angiostronsylus cantonensis — commonly referred to as the rat lungworm.
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The rat lungworm is considered the greatest cause of eosinophilic meningitis, and is sustained primarily from “ingestion of third-stage larvae in undercooked intermediate hosts,” such as the crayfish, in the woman’s case. However, the rat lungworm generally involves a different portion of the brain and “rarely causes simple white matter lesions.”
Following the determination of cause and diagnosis, the woman was treated with albendazole, a medication specifically aimed at treating parasitic worm infections. In the two weeks following the shift in treatment, the woman’s condition and symptoms improved, and she was able to resume regular function and communciation.
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