We’ve all found ourselves in situations we’d rather not be in, such as a school reunion, an endless work conference, or a distant relative’s wedding celebration. Making the most of such situations is often a wise option.
This is not just true for humans, but also for parasites, which are lifeforms that live inside and on us. This was the situation with Taenia solium, or pig tapeworm, which discovered itself in an unexpected location.
A middle-aged guy from Florida with a history of migraines visited the doctor because his headaches were worsening and not responding to his normal medications. The 52-year-old was taken for a CT scan, which revealed a startling finding: his brain was riddled with tapeworm cysts.
The most common way to get infected is by eating undercooked diseased pork that includes tapeworm cysts, also known as cysticercus.
When the parasite detects digestive juices in your small intestine, it knows it’s time to use its coiled hooks and four suckers to attach to your gut. Once within, the tapeworm lives its best life, growing to reach around two meters long and potentially residing in you for up to five years.
During this period, the parasite will lay thousands of eggs, either individually or by releasing portions of its body packed with eggs, all of which will pass through your feces. This type of infection is typically symptomless and can be effectively treated with antihelminthics (anti-parasite medications) with few consequences.
Although the reported patient admitted to eating uncooked bacon, this does not explain why the parasite was located in his brain, as consuming cysticercus in undercooked pork would result in an intestine illness.
Poor hygiene is the most likely cause.
The authors of this new study hypothesized that the patient was infected with the parasite’s intestinal form and then re-infected himself with eggs discharged in his feces due to inadequate hygiene.
Pigs typically consume the eggs that people pass in regions with insufficient hygiene and where feces can be utilized as fertilizer. Once within the pig, they hatch and go to the muscle to produce cysticercus, ready to be devoured again by humans.
In this situation, the parasite has reverted to its cysticercus form and, while seeking muscle, has unintentionally entered the brain via the bloodstream, resulting in neurocysticercosis. The parasite has made the best of the situation, as it can continue its lifecycle if scavenged after the host’s death.
Neurocysticercosis is also treated with antihelminthics, but the subsequent immunological reaction in the brain can cause more harm than good and must be suppressed with anti-inflammatory medications.
The reported patient chose this dual treatment and is healing with fewer brain lesions and headaches.
Neurocysticercosis, if left untreated, can induce seizures and is a leading cause of epilepsy in poorer countries with inadequate sanitation. Increased immigration from places where the tapeworm is endemic has led to an increase in cases, even in countries where livestock reports are rare.
Good personal cleanliness is the most effective approach to avoid this unwanted guest in your bowel or brain, where neither host nor parasite is happy.
Pigs have traditionally been a host for many parasites; after all, there is a reason pork was outlawed in many societies, and I avoid the present trend of “rare” pork, even at the most upscale places. Take a hint from the parasite: make the most of the situation and choose fully cooked pork, and you will be OK.
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