a woman lived with a worm in a vertebra

When this 35-year-old woman presented to the urgency of Dijon University Hospital, she probably did not suspect that the person responsible for all her illnesses was a small worm, well placed in his vertebra. For three months, the patient suffered from a weakness in the legs, accompanied by sensations of electric shock. These symptoms worsened, including repeated falls and difficulty riding. An unusual clinical case, which is the subject of a report published on July 12 in The New England Journal of Medicine.

Physical tests reveal a problem in the legs, and a blood test shows a very high rate of white blood cells and C-reactive protein, a sign of acute inflammation and possible infection. It is thanks to an MRI of the spine that the doctors begin to suspect something: the images reveal the existence of a lesion at the level of the 9th thoracic vertebra, also affecting the epidural space, which contains nerve roots.

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Dogs and cattle, hosts of parasites

Surgeons then proceed to the removal of this vertebra and affected epidural space, followed by osteosynthesis, an intervention that involves stabilizing the spine by supporting it with metal materials. Biological badyzes subsequently revealed the presence of a surprise guest: a Echinococcus granulosus a small worm that usually parasitizes the intestines of dogs, but also those of other pets or animals. 'breeding. It can happen in very rare cases that eggs of this worm are accidentally ingested by the man, thus leading to a hydatidosis, a parasitic disease.

How did this little worm get there? The young woman may have contracted the parasite by mouthing her hands contaminated by larvae, because of repeated contact with animals. Following hatching, the larvae would have made their way to the patient's vertebrae via the bloodstream. "This is a random and somewhat aberrant migration – the parasitic embryo has migrated and instead of going to the liver or lungs as most often, it has ended up in the vertebra," says Dr. Lionel Piroth , head of the infectious diseases department at the University Hospital of Dijon. The embryo then developed into a cyst, consisting of several larvae, which compressed its spinal cord where the nerves controlling the lower limbs pbad. The formation of the cyst being very slow, that explains the progressive appearance of the symptoms of the young woman. In humans, the disease never exceeds the larval stage, which can not develop into adult worms. The young woman escaped unscathed with pest control and, nine months after her back surgery, she was no longer showing any signs of the disease.

The mortality rate from hydatidosis is low. the order of 2 to 4%, but "it increases considerably in the absence of treatment, surgical and / or drug," says ANSES (National Agency for Food Safety, Environment and Labor ). To avoid contamination, it is necessary to wash your hands after each contact with animals or their droppings, advises the Ministry of Agriculture. For people who are often in contact with animals, work clothes, gloves and boots should be washed regularly.