(WJW) — A New England woman thought she was just dealing with jet lag after an extended vacation, but medical experts later diagnosed her symptoms as an infection from brain worms.
The woman, 30, felt fatigued when she got back from a three-week trip to Thailand, Japan and Hawaii, according to a case study published last week in the New England Journal of Medicine.
She brushed it off at first, but then the woman started experiencing a burning sensation in her feet that, within two days, spread to her legs and “worsened with light touch,” reported Dr. Carlos A. Portales Castillo, with Massachusetts General Hospital, in the case study.
The woman went to the emergency room and tests came back normal, aside from a high count of eosinophils, “a type of white blood cell that protect your body from parasites, allergens, foreign bacteria and outside organisms,” according to the Cleveland Clinic.
She was released from the hospital and was told to follow up with her primary care doctor, but a couple of days later, the burning sensation spread to her arms and she started suffering from a headache that wouldn’t ease up with pain medication, the case study said.
The woman went back to the emergency room at a different hospital where test results were still coming back normal aside from a high white blood cell count.
The woman woke up confused the next morning, thinking she had to pack for vacation and her roommate struggled to get her to lie down, the case study said.
She remained confused for hours and her roommate took her to the Massachusetts General Hospital where doctors took a closer look at the food she ate while on vacation.
Doctors determined the woman ate raw foods like sushi and salad while in Tokyo and Hawaii.
They diagnosed her with eosinophilic meningitis, a condition caused by angiostrongyliasis, or human infection with larvae of the rat lungworm, according to the National Institute of Health.
In the case study, Dr. Joseph Zunt pointed out that human infection is distributed across many tropical and subtropical areas of Southeast Asia and the Pacific Islands, including Hawaii.
The Hawaii Department of Health describes angiostrongyliasis as “a disease that affects the brain and spinal cord.”
The health department said the adult parasite is only found in rodents, but they can pass larvae through their feces.
“Snails, slugs, and certain other animals (including freshwater shrimp, land crabs and frogs) can become infected by ingesting this larvae; these are considered intermediate hosts,” the department said. “Humans can become infected … if they eat (intentionally or otherwise) a raw or undercooked infected intermediate host, thereby ingesting the parasite.”
The Hawaii Department of Health reported seven confirmed cases in the state in 2024. As of Feb. 3, there have been no confirmed cases in 2025.
The woman was treated in the hospital with prednisone and albendazole, a medication used to fight infections caused by parasites. She was released after six days, according to the case study.
