Health experts are sounding the alarm regarding the rare symptoms associated with a distinctive parasitic infection prevalent in Hawaii.

A woman from New England, aged 30, experienced a burning feeling in her legs and feet, which led to the surprising discovery of parasitic worms in her brain.

She sought medical help at a hospital after facing severe headaches and a burning sensation that traveled from her feet up through her arms.

Having recently returned from a trip to Thailand, Japan, and Hawaii, she had consumed raw fish, which doctors suspect may have introduced the parasites.

Initially, the woman hailed from a coastal community in New England and visited two emergency rooms, where her symptoms were downplayed, and she was sent home with prescriptions for headache relief and anxiety.

It wasn’t until her cognitive confusion worsened that she underwent further testing in the hospital, which included a lumbar puncture to assess her condition more accurately.

This procedure provided critical insights, leading to the diagnosis of angiostrongyliasis, a rare parasitic infection caused by the roundworm Angiostrongylus cantonensis, commonly referred to as rat lungworm.

This infection resulted in inflammation of the membranes enveloping the brain and spinal cord, causing sensations of burning or shooting pain in her limbs.

Doctors are warning about the association between burning sensations in the legs and a rare parasitic infection found in Hawaii (stock image)

Twelve days prior to her hospitalization, this individual had embarked on a three-week journey.

Her travels included a week in Bangkok, Thailand, where she indulged in various street foods while avoiding raw dishes.

Following that, she spent five days in Tokyo, Japan, primarily enjoying sushi within her hotel.

For the last ten days, she vacationed in Hawaii, frequently swimming in the ocean and often eating salads and sushi.

Initially, doctors suspected Guillain–Barré syndrome, a rare autoimmune disorder where the body’s immune system incorrectly attacks peripheral nerves. However, her normal physical examination rendered this diagnosis unlikely.

Other potential causes such as ibuprofen usage and a rare condition known as eosinophilic granulomatosis were also eliminated.

As her symptoms intensified, including headaches and fever, doctors performed a lumbar puncture, which indicated eosinophilic meningitis—an inflammation of the brain and spinal cord membranes.

The probable source of her condition was identified as Angiostrongylus cantonensis, typically found in tropical areas.

This roundworm has gained attention in recent years in Hawaii, amid small outbreaks within the state. In 2017, 19 confirmed cases were reported, but numbers have since remained under ten annually.

The parasite’s life cycle involves slugs, snails, and rats. Rats discharge first-stage larvae through their feces, which are consumed by snails or slugs, where they grow into third-stage larvae (L3).

When rats consume infected slugs or snails, the larvae travel to their brain, mature, and move to the lungs to reproduce. This cycle continues as rats excrete the larvae.

Humans become infected by ingesting L3 larvae, generally through undercooked snails, slugs, or contaminated vegetables, particularly leafy greens in contact with infected slugs.

Once in the body, the larvae migrate from the digestive system to muscles and the brain, causing sensations like burning feet. Generally, the larvae do not reach maturity in the human brain.

In this case, the woman likely ingested the larvae through food contaminated with snail or slug slime.

Her treatment included a combination of medications to address both her symptoms and the parasitic infection. A 14-day high-dose course of prednisone, a steroid, was initiated to alleviate inflammation and manage symptoms such as headaches and nerve discomfort.

Additionally, albendazole, a drug specifically targeting the parasite, was prescribed as it effectively penetrates the brain and spinal fluid, administered alongside prednisone.

To alleviate nerve pain, gabapentin and amitriptyline were also employed. Thanks to these treatments, her symptoms improved significantly, eliminating the need for further tests or interventions.

By the sixth day, her condition had improved enough for her to be discharged from the hospital.

The quick diagnosis and strategic combination of treatments were pivotal to her recovery.

If untreated, this condition can be life-threatening.

Inflammation of the membranes surrounding the brain and spinal cord may result in elevated intracranial pressure, neurological impairment, and serious complications, including seizures, strokes, or even coma. In certain cases, the infection or inflammation can spread to other body areas.