The tingling of the woman turned out to be parasites on her back

Chamber in Dijon, France, said she had had trouble riding her horse for three months. His symptoms were aggravated, from weakness to falling and electric shock to both legs.

After a battery of tests, doctors discovered a parasitic worm that was hiding in his spine.

When Drs. Marine Jacquier and Lionel Piroth of the University Hospital Center of Dijon performed an MRI examination of the spine, they found an abnormal lobed ball in its ninth thoracic vertebra, as well as a picture recently published in the New England Journal of Medicine . Other tests revealed that the tapeworm, Echinococcus granulosus, had caused the woman's symptoms.

When they first saw MRI, "to be perfectly honest, we could not imagine the echinococcosis". He submitted the image to the journal to educate doctors about the possibility of this disease, which is rare in France and in the region of the woman's body.

Echinococcus worms mainly cause two diseases in humans: echinococcal cysts and alveolar echinococcosis. The disease is zoonotic, which means that it is transmitted to humans by animals, in this case dogs, which in turn are infected with ungulates such as cattle or sheep. According to the World Health Organization, which classifies echinococcosis among neglected tropical diseases, more than one million people worldwide have echinococcosis at some point.

But if the disease is certainly neglected, it is not just tropical. Dominique Vuitton, professor emeritus at the University of Franche-Comté and member of the WHO Collaborating Center for the Prevention and Treatment of Human Echinococcosis. Almost every country in the world has seen cases of the disease, added Vuitton, who was not involved in treating the woman.

Although it is rare to see Echinococcus in developed countries, the parasite causes disease in 10% of the population. endemic countries such as Argentina, Peru and China, according to WHO. In the hyperendemic regions of South America, between 20% and 95% of slaughtered animals have the disease.

The doctors reported that the 35-year-old woman had never traveled abroad but owned a cat and had contact with cattle. She explains how the woman could have been infected with the worm – but according to Dr. Christina Coyle, director of the Jacobi Hospital's Tropical Medicine Clinic and professor of medicine at Albert Einstein's College of Medicine, the cat and the cattle are red herring, since the disease is usually transmitted to humans by dogs.

Humans can become hosts to the parasite when they ingest its eggs, which are present in the feces of an infected dog, according to the United States Centers for Disease Control. Prevention. Piroth stated that the woman had reported no contact with dogs, and that she had not traveled to any area where the disease was endemic, such as Corsica.

"We have no idea how it was contaminated." she may have eaten food or vegetables contaminated by an infected dog.

Once swallowed, the eggs hatch and migrate through the circulatory system to various organs, beginning with the liver. Vuitton said that about 65% of lesions (which betray the location of the worm) develop in the liver, 20% in the lungs and the rest elsewhere, including the brain, bones and sometimes the vertebrae .

Most people with echinococcosis are asymptomatic, Coyle said. When the parasite develops in the liver, cysts tend to develop over several years; in the case of this woman, however, the cyst moved its spine as it grew – and caused symptoms.

The MRI examination of the woman's back was remarkable for the experts; Piroth said the lesion looked like "a little flower" and Vuitton said the picture was "very, very beautiful" because she was showing the woman's cyst very clearly.

However, she was "surprised" that the newspaper publishes the doctors. note without requiring a more precise identification of worm species and information on where the woman might have been exposed.

After discovering the woman's cyst, the doctors surgically removed the lesion and placed the patient on the albendazole pest control drug. Nine months later, the woman had no residual symptoms or signs of recurrence, according to the report.

Vuitton stated that albendazole is the only medication offered to treat patients and that about 20% of patients include hepatic toxicity. The drug should be used in tandem with the surgery, and even then, it is not 100% effective.

"After 40 years of using albendazole, we have nothing new that is really effective against the disease." According to WHO, prevention programs are focused on the regulation of the slaughter of animals and deworming of dogs and sheep, which are the definitive hosts of the disease.

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