GP diagnosed neck lumps in cat caregiver as worms from her cat. He was wrong.

Francesca Knee-Wright, from Brighton, had only given birth to her second child three months before she noticed a 'very small' lump on her neck. She had it checked out and was told to watch and wait. More lumps developed and her GP told her that they were caused by parasitic worms (endoparasites - probably roundworms) that she had acquired from her two Spanish rescue cats.

Francesca Knee-Wright. Image: Kennedy News and Media

She queried this and a second opinion diagnosed something entirely different and far more serious: Hodgkin's lymphoma which is a relatively aggressive form of blood cancer that can quickly spread through the body.

She is on chemotherapy and shaved her hair to stop the difficult emotional effect of watching her hair fall out.

Having read the story I did some research on the roundworm and whether it could cause lumps as described. They can.  Here is the lowdown:

Can roundworms in cats be transmitted to humans?

Yes, roundworms in cats can be transmitted to humans, specifically through a process called zoonotic transmission. This type of transmission usually happens if a person accidentally ingests roundworm eggs, which are shed in the feces of infected cats. These eggs can survive in soil, sand, and other outdoor environments for long periods, making it relatively easy for humans to come into contact with them, especially in areas frequented by cats.

In humans, roundworm larvae can migrate through body tissues in a condition known as toxocariasis, which can affect the liver, lungs, eyes, and other organs. Children are particularly vulnerable because they are more likely to come into contact with contaminated soil or sand and might not practice proper hand hygiene.

To prevent transmission, some key measures include:

• Regular deworming of pets, as advised by a veterinarian
• Practicing good hygiene, especially washing hands thoroughly after handling cats, cleaning litter boxes, or coming into contact with soil or sand
• Covering sandboxes to prevent animals from using them as litter boxes
• Avoiding bare-hand contact with soil or areas where cats might defecate.

If you have any concerns about toxocariasis or the possibility of exposure, consult a healthcare provider for advice on testing and treatment.

And these worms inhabit the gut of the human. Correct?

Actually, no—roundworms in humans generally don’t mature in the gut as they do in cats. Instead, when humans accidentally ingest roundworm eggs, the eggs hatch in the intestines, but the larvae don’t settle there. Instead, they migrate through various body tissues in a process called larval migrans.

There are two primary types:

1. Visceral Larva Migrans (VLM): The larvae travel to organs like the liver, lungs, and sometimes the brain. This can cause symptoms like fever, fatigue, coughing, or abdominal pain, depending on which organs are affected.

2. Ocular Larva Migrans (OLM): Sometimes, larvae reach the eyes, which can lead to eye inflammation, vision problems, and even vision loss if untreated.

Since roundworms don't complete their life cycle in humans, they can’t develop into adults in the gut. Instead, they become trapped in body tissues, where they eventually die but may cause inflammation and other symptoms.

And the larvae mature to adult worms in these locations?

No, in humans, roundworm larvae do not mature into adult worms. Instead, they remain in the immature larval stage throughout their lifecycle in human tissues. After hatching in the intestines, the larvae migrate to various organs and tissues but lack the necessary environment to mature fully as they would in a cat or other definitive host.

In these human tissues, the larvae often cause localized inflammation as they move through, but they eventually die off without maturing into adult worms. This can still result in significant symptoms, especially if they reach sensitive areas like the eyes or organs, but full-grown adult worms are not seen in human cases of roundworm infection.

Can they cause lumps in the neck?

Yes, roundworm larvae migrating through human tissues can, in some cases, cause lumps or swollen areas, although this is less common. When the larvae travel through or lodge in tissues, they can trigger an immune response, leading to localized inflammation or granulomas (small nodules formed by immune cells around the larvae).

In the neck, this could potentially result in lumps if the larvae pass through lymph nodes or surrounding tissues, but it’s more typical for them to affect organs like the liver, lungs, or eyes. Swollen lymph nodes in the neck can also react as part of a systemic immune response to the infection, although this symptom can be caused by a wide range of other conditions.

If there’s a persistent lump or swelling in the neck, it’s best to consult a healthcare provider for an accurate diagnosis, as they may recommend tests to rule out or confirm conditions like toxocariasis.

------------

P.S. please forgive the occasional typo. These articles are written at breakneck speed using Dragon Dictate. I have to prepare them in around 20 mins. Also, sources for news articles are carefully selected but the news is often not independently verified. And, I rely on scientific studies but they are not 100% reliable. Finally, (!) I often express an OPINION on the news. Please share yours in a comment.