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July 9, 1982

One worm in the minnow equals too many in the gut

JAMA. 1982;248(2):163. doi:10.1001/jama.1982.03330020011004

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The physician could hardly believe what he was seeing through the laparoscope. A bright red worm, 15 cm or more long, was wriggling through the patient's intestinal wall into the abdominal cavity.

Then, astonishingly, yet another blood-red worm emerged from the intestine.

The scene was an operating room of Franklin Square Hospital in Baltimore not long ago. Within a matter of days, physicians there saw three patients with the same problem. Two required abdominal surgery, and the other was treated medically.

The Franklin Square physicians turned to the School of Hygiene and Public Health at the neighboring Johns Hopkins Medical Institutions with the obvious question: What is this worm? Where does it come from? Why are we suddenly seeing patients with this problem?

Everett Schiller, ScD, of the school's Tropical Medicine Center concluded that the worm is a species of the genus Eustrongylides, a roundworm that lives in fish-eating birds