When you are suffering a migraine headache, your first thought may not be that you have tapeworms in your brain. That may not be your second thought or even your 17th thought. But baby pork tapeworms are exactly what doctors found in a 52-year-old man’s brain after he went to a clinic complaining that his migraine headaches had been getting more frequent and severe over the course of four months. A case report published in The American Journal of Case Reports detailed what happened to this man who had a nearly lifelong habit of “eating lightly cooked, non-crispy bacon.” Yeah, eating lightly cooked broccoli is one thing. Eating lightly cooked bacon is something totally different.
The case report—authored by Eamonn Byrnes, Brian Shaw, Mario Madruga and Stephen J. Carlan from the Orlando Regional Healthcare System and Ryan Shaw from the University of South Florida—detailed what happened to this man who had already had a history of migraine headaches being managed by medications as well as type 2 diabetes mellitus, hyperlipidemia, and obesity. But over the four months preceding his visit to the clinic, his migraines had increased in frequency to nearly a weekly occurrence and become resistant to his usual headache medications. That prompted the man to see a doctor in Orlando, Florida, where the findings eventually led to the man undergoing CT and MRI scans of his head and being admitted to the hospital.
The CT and MRI scans showed numerous cysts on both sides of his brain. To assist the diagnosis of these cysts, his doctor ordered a bunch of blood tests, one of which revealed that the man had antibodies against Taenia solium. Taenia solium is the scientific name for a pork tapeworm. This confirmed that the man had neurocysticercosis, which is when cysts containing the larval forms of Taenia solium are present somewhere in one’s central nervous system such as the brain or the spinal cord.
Now, having such cysts in your brain is sort of like having random strangers camp out in your living room and bathroom. The cysts can be quite disrupting, resulting in inflammation and fluid accumulation. This in turn can lead to headaches, various neurological deficits, increased blood pressure in the brain, cognitive decline or seizures, with seizures being the most common presentation. Having such cysts in your brain is not like having a bunch of pimples on your face. It could lead to life-threatening situations. So doctors started the man on dexamethasone to reduce this fluid in his brain.
The doctors also gave the patient two types of anti-parasitic medications for two weeks—oral albendazole 600 mg twice a day and praziquantel 1800 mg three times a day. Giving such medications was not necessarily a no-brainer so to speak since destroying the cysts can cause even more brain inflammation. But the doctors decided that getting rid of the larvae was worth the risk. Eventually, the patient became stable enough for discharge from the hospital. The treatment subsequently led to the regression of the lesions in the brain and improvement of the man’s headaches. One would guess that he curtailed his habit of eating lightly-cooked bacon too because such undercooked pork products could contain the larvae of Taenia solium.
Here’s the poop, though, the man probably didn’t get neurocysticercosis directly from eating such bacon. Instead, poop was probably somehow involved. Taenia solium is called the pork tapeworm because it’s typically passed among pigs. Humans can get in on the action in two ways. One way is by consuming raw or undercooked pork that contain the larval form of the parasite known as cysticerci. Once in your gastrointestinal tract these cysts evaginate—which may sound dirty but means that the cysts turn inside out—and attach themselves to the walls of your small intestine. There they grow and mature into adult worms over the course of around two months. This type of tapeworm infection is called taeniasis.
These adult tapeworms can produce proglottids, which are pieces of the tapeworm that contain both male and female reproductive organs. After these proglottids detach from the tapeworm, they can migrate to your anus. In the end, any poop that go through your anus may as a result carry these proglottids and the eggs that they produce.
This brings up the second way of that humans can insert themselves into this pig-tapeworm circle of life: by consuming something contaminated with feces containing these eggs or proglottids. After such eggs go down your hatch and make it to your intestines, they can hatch, releasing tapeworm larvae. These larvae don’t just hang out in your intestine as is the case with taeniasis. Instead, they can then penetrate your intestinal walls and get into your bloodstream. Your bloodstream can then serve as a superhighway to the rest of your body, allowing the larvae to travel to and embed themselves into your muscles, brain, liver, and other places. There they develop into cysticerci, hence the name of this kind of pork tapeworm infection: cysticercosis.
Given that this man had presented with neurocysticercosis rather than taeniasis, he probably at some point consumed poop that carried eggs or proglottids. Since he didn’t have a history of hanging out with or partying with pigs, one strong possibility is that he developed taeniasis from eating the undercooked bacon and then “autoinfecting” himself. In other words, the taeniasis from the bacon led to his having eggs or proglottids in his poop and at some point that poop probably made its way into his mouth. After all, when you don’t wash your hands thoroughly and frequently, poop there is—on your hands and everything your hands touch.
Of course, neurocysticercosis isn’t a common occurrence, which is why it qualified as a case report in a medical journal. Nevertheless, all of this should be a reminder that it isn’t good to eat poop, even your own. And it’s not a good idea to consume any pork products that aren’t from trusted sources and cooked thoroughly. Otherwise, the consequences could end up being quite a headache.
