A California man pulled a 5-foot, 6-inch tapeworm out of his body following a steady diet of salmon sushi, his doctor said.
After asking the man if he had traveled out of the country or drank well water in the past year, Dr. Kenny Banh, an emergency room physician at the University of California San Francisco in Fresno, discovered that the man ate raw salmon sushi "almost every day," which could be the way the parasite entered his body.
The patient, who was not identified, has since sworn off salmon sashimi forever.
Banh told the podcast This Won't Hurt a Bit that the young man had approached him during a shift complaining of bloody diarrhea and asking for treatment for worms in early August 2017. Banh said he was skeptical of the man's request because people often unnecessarily demand treatment for worms, but the man had wrapped the giant parasite around a toilet paper roll and carried with him to the hospital in a grocery bag.
The man first thought the worm was a piece of intestine hanging out of his rectum after he had diarrhea, Banh said, but after pulling the worm out of himself, he saw it start wriggling. The worm was as long as Banh is tall, the doctor said.
Banh said he "geeked out" about the worm, the largest he had ever seen from a patient, and showed it to about 40 people in the hospital. The hospital's pharmacist, on receiving the request for deworming medication, left the pharmacy to see the worm, according to Banh.
People sometimes ingest tapeworms intentionally as a medically dubious weight-loss technique, but Banh said the patient reported not losing any weight of late.
He was also suspicious of the man's pledge never to eat raw fish again.
"It's like with patients who come in after motorcycle accidents," he said. "They say they'll never ride again, but then I'll see them in the emergency room after another accident. It's hard to give up something you love."
According to the Centers for Disease Control, salmon from Alaska and Asian Pacific coasts can carry tapeworm larvae, which is becoming a bigger problem as eating raw fish becomes more popular worldwide. Tapeworms can cause abdominal pain, anemia, diarrhea, and loss of appetite, and grow to be much longer than 5-and-a-half feet. One preserved specimen measures 8.8 meters.
The CDC recommends flash freezing or cooking fish to kill parasites. According to the American Society for Microbiology, tapeworms and the diseases they cause affect roughly 20 million people worldwide.
Treatment for tapeworms entails taking the same kind of deworming medication that dogs do, which is what Banh said he prescribed to the man with the giant tapeworm. Banh said the patient may "poop out a bunch of worms" in the future.
Banh prescribed the patient the same kind of deworming medication that's used for dogs. An earlier version of this post suggested he prescribed something much more objectionable!