Live tapeworm, 'still wiggling,' removed from California man's brain

Luis Ortiz can’t remember much about his nearly three-month hospital stay this fall. He said his brush with death started with an intense headache.

After suffering debilitating pain that spurred fits of vomiting, Ortiz was taken to a Napa Valley hospital, where doctors found a live tapeworm trapped in the depths of his brain.

“It was still wiggling and moving around,” the 26-year-old Napa native said.

Doctors don’t know how long the worm had been living inside Ortiz, but it likely moved its way from another part of his body and settled into a ventricle in the middle of his brain, said Janet Bruneau, an acute care nurse practitioner at Queen of the Valley Medical Center.

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How the parasite entered Ortiz’s body is a mystery. Swimming in an infected lake, eating uncooked pork or dirty fruits and vegetables could do it. But Ortiz said he can’t remember doing any of those things.

Tapeworm infection is mostly found in developing countries, including Latin America, Asia and Africa, where poor hygiene tied to poverty is more prevalent, according to the Centers for Disease Control and Prevention. Patients can get tapeworms when they eat or come in contact with food, water or other surfaces contaminated with their eggs. The disease can result in death in cases where the tapeworm forms cysts that spread to the brain and spinal cord.

If Ortiz would have delayed even a half-hour before going to the hospital, his condition could have proved deadly.

Ortiz’s medical woes began in late August when the pounding headaches began.

His memory of the day is fuzzy, but he recalled traveling from Sacramento to visit his family in Napa. Ortiz attends Sacramento State University, where he is studying science and psychology.

After arriving home, he met up with a friend and went skateboarding. That’s when his troubles began. He blacked out a few times and decided to head home for the evening.

At home, his headache worsened, and the vomiting spells started.

“My head was really throbbing,” Ortiz said.

When he blacked out, his parents drove him to the hospital, where doctors immediately performed a CT scan X-ray exam and discovered swelling in his brain.

To relieve the pressure in his brain, doctors created a small hole in his head for drainage. Next, doctors performed a more detailed X-ray exam of his brain to get a better picture of what was causing the swelling and fluid obstruction.

The X-ray showed a sphere-like cyst one-centimeter in diameter. A closer look revealed it was a “little, itty bitty worm,” or a scolex — the end of a tapeworm with suckers that attach itself to the body, Bruneau said.

Ortiz’s condition rapidly deteriorated, and doctors had no other option but to remove the worm, which required a neurosurgeon with a deft hand.

Dr. Soren Singel had to create a map of Ortiz’s brain and head, then use a brain-navigating system and an endoscope-like device to reach the cyst.

Bruneau said the complicated surgery could best be described as though standing at the end of a 20-foot room, then having to use a straw to reach a point, or a dot, on the other side of the wall.

The surgery is further complicated by the risks of rupturing the cyst and spilling its content onto the brain, possibly resulting in an infection.

Singel was able to remove the whole cyst safely.

The ordeal left Ortiz with some memory loss. He needed cognitive therapy and rehabilitation, but he was released from therapy before Halloween.

“I am just happy to be alive,” Ortiz said. “I got lucky.”

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