She lived with a worm in the vertebrae – Edition du soir Ouest France



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Last fall, a 35-year-old woman presented to the emergency department in the Dijon region. To doctors, she complains of back pain, sensations of "electric shock" in the legs, loss of balance. For three months she has struggled to ride. This is the beginning of the story told in an article published by the head of the infectious diseases department of the University Hospital of Dijon, Lionel Piroth, in New England Journal of Medicine. A publication intended for health professionals, to report a more than unusual case.

Following examinations, the doctors realize that the patient is home, in the ninth vertebra of her back … a tapeworm: a flat worm. "This is the first time I see this", testifies the professor, contacted by The evening edition. Their patient is suffering from hydatidosis (hydatid echinococcosis), a disease caused by the accidental ingestion of parasite eggs, often in contact with animals (dogs, cattle, etc.), sometimes by ingesting food soiled with Feces

Of unknown origin

This disease, which is much more prevalent in the tropics than in our latitudes, is present throughout the world. According to the World Health Organization (figures for February 2018), the four different forms of human echinococcosis currently affect more than one million people. In parts of East Africa, China or Argentina, up to 5-10% of the population is affected. In 2015, the WHO reference group estimated that echinococcosis accounted for 19,300 deaths worldwide. In its hydatid form, the mortality of the disease is estimated at 2 to 4%, not to mention the serious consequences on the quality of life.

An example of the complex parasitic cycle of hydatidosis: in the gut of the dog, the adult tapeworm produces eggs. They are ingested by the sheep, who develop cysts … that can infect other dogs … (Illustration: USCDC / Public Domain).

In France, it is much rarer, but it exists. The reasons why this 35-year-old woman was affected remain unknown: "One could formulate hypotheses. She was in contact with cattle, horses But in reality, we can not know, " notes Professor Lionel Piroth. Nor did she return from a trip to areas where the disease is endemic, the most frequent case of contamination.

"She risked quadriplegia"

In her case, "the parasite was wrong way. " The larva that infected the patient moved into her body, via the blood vessels. The tapeworm ended up staying in an extremely rare place: in the ninth vertebra of his back. "The worm began to tickle the spinal cord, which is why it felt these pains. If nothing had been done, she was likely to be tetraplegic.

The worm could have done a lot of damage to the patient's spinal cord. She's fine today. (Illustration: Screenshot New England Journal of Medicine).

Very delicate, given the affected area, the operation went well. With ten months of follow-up and antiparasitic treatment, the patient has no sequelae. Fortunately for her, no other worm had settled in her body. For Lionel Piroth, the interest of such a publication is primarily medical, to allow other doctors to know that this type of case can happen. For the population, it is rebaduring: "It is a disease that exists in France, that we know, that we treat. Most of the time, people from endemic areas, abroad, are affected. People do not have to worry. "

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