Back in September, surgeons at Mount Sinai Hospital in New York were scrubbing up in preparation for a major surgery. They were planning to open up a woman's skull to extricate a malignant brain tumour. What they found instead was something else.
Rachel Palma had come to her doctor in 2017 complaining of a variety of symptoms. It started with prolonged bouts of insomnia for the 42-year-old newlywed. When she could sleep, she complained of horrible nightmares. SHe was also experiencing hallucinations, imagining things that weren't happening.
Mount Sinai Health System
By January 2018, things had gotten worse. She was starting to have trouble holding things, dropping a coffee mug even though she was focusing on it. It got so bad she had to start calling everyone because she couldn't text anymore.
Then came the confusion. She locked herself out of her house, showed up for work without her uniform, found herself staring at a computer screen unable to understand the words. At one point, she even called her parents and left a message saying that the place she had bough her bed from years ago suddenly wanted it back.
Eventually, after multiple visits to doctors and specialists at Mount Sinai, they identified a lesion on her frontal lobe, near the speech center. Malignant brain cancer. Palma was devastated, and agreed to brain surgery.
But when surgeons got into her head, expecting to cut out a brain tumour, they instead found a mass of something whitish, almost like a tiny bird egg.
"We were all saying, 'What is this?' " Jonathan Rasouli, chief neurosurgery resident at the hospital, told The Washington Post. "It was very shocking. We were scratching our heads, surprised at what it looked like."
Mount Sinai Health System
"Of course I was grossed out," Palma said about having a tapeworm egg in her brain. "But of course, I was also relieved. It meant that no further treatment was necessary." She was officially diagnosed with neurocysticercosis, a parasitic infection in the brain caused by the tapeworm Taenia solium.
Taenia isn't common to the US. When it does present however, it's in one of two ways. The most common way to get an adult tapeworm of this kind is by ingesting undercooked pork, where the tapeworm is living inside the animal's gut. But how did it get in her brain?
Well, there's another way to get it.
When the tapeworm lays eggs, they're shed in a person's stools. But if they transfer onto the patient's hands, and they don't properly wash (gross) they can pass the eggs on to other people.
For instance, if someone in a restaurant kitchen has a tapeworm, visits the bathroom but doesn't wash up properly, and then prepares your food, you can end up eating those microscopic eggs. The eggs then travel to the small intestine, where they hatch into larvae. These larvae then burrow through the walls of your bowel, getting into your bloodstream, and get a free ride to anywhere in your body. In Palma's case, that was to her brain, where the larva was like a fluid-filled cyst.
The adult form of the tapeworm is easily treated with an anti-parasitic, but getting rid of larvae is more complex. It also depends on the stage of infection, and where it's located.
Luckily for Palma, her infection was easily enough removed during the surgery. Now, she says her symptoms have "almost 100 percent" vanished. Mull over that nightmare fuel.