Chapter 242: An Elusive Parasite

The human nervous system is one of the trickiest and most unpredictable parts of the body. Sometimes, even a tiny misfire can have a huge impact on a patient.

Epilepsy and sinus node arrhythmia are among the most common nervous system disorders that result from abnormal electrical activity.

The vagus and sympathetic nerves in the body can sometimes act up like mischievous kids. When something goes wrong with them, all kinds of neurological issues can pop up.

This patient had already undergone a 24-hour EEG at another hospital, but nothing major came up.

A head CT was also performed, and a brain tumor was basically ruled out.

“I’ve checked the patient’s blood work—the white cell count is normal, but the eosinophil levels are slightly elevated.”

Zhou Can didn’t rush to reveal his diagnosis. Instead, he started sharing some of the odd findings he’d noticed.

“There are so many reasons for elevated eosinophils! Common causes include allergic diseases, bronchial asthma, hives, drug allergies, allergic purpura—you name it. Even skin conditions and cancer can do it. Wait, you’re not suspecting a parasite infection, are you?”

Director Shang suddenly picked up on the direction Zhou Can’s thinking was headed.

Eosinophilia mostly shows up in allergies or parasitic infections. Diseases like schistosomiasis, ascariasis and hookworm can all lead to increases in this count.

But in this case the patient’s eosinophils were only mildly elevated, and a stool test had already been done at the hospital. If there were any parasites, they would’ve shown up long ago.

So, not only Director Shang, but the other doctors also quickly ruled out a parasite as soon as they saw the results.

After all, parasitic infections usually come with a host of obvious symptoms.

Not just random, unpredictable vomiting.

“I think there’s a strong chance the patient is infected with a parasite—a truly nasty one that’s easy to overlook. These are often found in snakes and frogs.”

Zhou Can said this with a smile.

He was probably the only trainee who dared chat so casually with a senior physician.

Even took a playful jab at suspense.

“Dr. Zhou, are you thinking of sparganosis?”

Xie Lin jumped in with her question.

“You got it—that’s the one. Of course, this is just my preliminary suspicion, I can’t say for sure yet. We’ll need more tests to confirm it.”

Zhou Can wasn’t entirely convinced himself. He just suspected it might be the case.

After all, the patient’s brain CT was normal. If sparganosis was there, it could have shown up on the scan.

“I don’t think that’s possible!”

Director Shang’s face grew even more serious, eyebrows knitted tight.

He’d reviewed all of the patient’s records and CT from other hospitals. Even though he wasn’t an expert in neurology, with decades of experience he believed he’d spot anything really abnormal on a brain CT.

“Did you notice how often the patient raised his right hand to scratch his head? Before he left just now, I took a closer look and saw a small bump on his scalp that rose and then sank back down. Scalp tissue shouldn’t move like that. Plus, his wife said he’s been scratching his head since before he got sick. My gut says that’s a parasite moving under the skin.”

Zhou Can continued explaining the reasoning behind his diagnosis.

Director Shang silently admired how keenly observant this kid was.

After thinking for a moment, he looked at Zhou Can and asked, “Even if there’s a parasite in his brain, how can you be sure it’s sparganum?”

Every doctor approaches problems differently, reasons differently and ends up with completely different diagnoses.

There are just too many types of parasites that can infect the human body.

You couldn’t name them all if you tried.

But Zhou Can zoomed right in on sparganosis, which caught Director Shang’s attention.

“Well… I narrowed it down in a few ways. The affected area is in the brain. Sure, cerebral schistosomiasis, cerebral ascariasis, and neurocysticercosis can all get into the brain, but their symptoms and sizes don’t quite fit. Only sparganum is this stealthy. Before it causes obvious symptoms, you’d never know it’s there. Even when it finally acts up, it’s often mistaken for a glioma or something similar.”

Sparganum is very different from roundworms.

They’re extremely picky about where they live—they don’t like filthy intestines. Instead, they’ll find a way to enter the host’s brain through the bloodstream or other routes.

Once they settle in an ‘upper floor’, the environment is clean, and they’re much harder to find.

Roundworms, by comparison, are much less sophisticated. If anything stirs them up, a simple stool test at the hospital can spot eggs or larvae. Sometimes, if someone’s infested enough, a live worm might even pass out during a bowel movement.

That really raises the chances of getting caught.

Sparganum hiding out in the brain, meanwhile, doesn’t eat or excrete through the digestive tract at all, so it’s way less likely to get discovered.

“Plus, most other parasites cause a lot of different symptoms. Like schistosomiasis—the eggs settle in the liver, intestines, bladder, or the reproductive organs and cause granulomas and fibrosis. Adult worms can lead to weight loss, anemia, stomach pain, an enlarged liver, and those distinctive swollen bellies. These signs are easy to spot and diagnose. But sparganum just lurks in the body, slowly growing, extremely hard to detect.”

“One more thing—this patient often goes to business dinners and eats all sorts of exotic dishes. Frog and snake meat are local specialties and really popular, which raises his risk of infection.”

You hang out at the riverbank long enough, you’re bound to get your feet wet.

Eat a lot of frog and snake, and even if you cook them, if they don’t boil long enough or don’t get fully cooked, sparganum can survive. Once it gets into the stomach, don’t count on stomach acid to kill it. Almost every parasite is tough—heat-resistant, acid-resistant, you name it.

If they weren’t built that tough, they wouldn’t be parasites in the first place.

Some people think stomach acid will take care of them, or that the digestive tract will just flush them out—better not pin your hopes on that.

Their survival and adhesive abilities are out of this world.

“Bringing everything together, that’s why I suspect sparganum is causing all this trouble.”

Zhou Can’s analysis was spot-on, both logical and highly practical.

Director Shang and Dr. Huang Xinggui nodded repeatedly. Xie Lin and Luo Jingyin, the two female grad students, were even more impressed. Even Qiu Chengyu, whose plans Zhou Can had disrupted, couldn’t deny his diagnostic skills.

He was just that good.

As a grad student, he could only look up to Zhou Can.

“The imaging lab should still be open, right?”

Director Shang turned to ask Dr. Huang Xinggui.

“It probably is. Most imaging departments close at six.” Dr. Huang seemed to know what Director Shang was thinking—he looked eager and excited. “Are you planning to get the patient’s head scanned again right away?”

“Absolutely! Lots of things in life can be delayed, but not illness. The patient’s condition is serious—the sooner we diagnose and treat it, the better.”

Director Shang wasn’t just highly skilled—he really cared about his patients.

At the thought of finally getting a diagnosis, he couldn’t wait another minute.

“Call the imaging department—have the CT techs stay late. I’ll talk to the family and file the request. You can all come along and watch the real-time brain scan. It’ll be good experience.”

Every trainee rotates through the imaging department for a month.

It’s to get hands-on practice with ultrasound, CT and X-rays—learning how everything works, spotting key signs, that kind of thing.

Zhou Can hadn’t done his imaging rotation yet. He planned to finish up in internal medicine, then do a month on imaging.

By that point, his 36 months of training would be done.

He’d be ready to join the Emergency Department as a full-fledged doctor.

Director Shang made decisions quickly and went right to talk with the family.

Zhou Can and the three grad students followed along.

Part of it was to help find the family—no one knew if they’d reached the inpatient unit yet. Part of it was to learn. Watching senior doctors talk to families is great training for newcomers.

To their surprise, the patient’s wife moved quickly.

Maybe it was from years of seeking medical help—she knew every step by heart. Even at a new hospital, she’d finished the admission process in no time.

By now, she had her husband settled on a temporary folding bed, set up by the nurse.

These temporary beds are the folding kind for easy storage.

They’re smaller than regular hospital beds.

Only big enough for one adult to lie on.

But for a patient, just having a bed and getting admitted was reason enough to be grateful.

Comfort was the last thing on his mind.

A hospital isn’t a hotel. Patients come to get well, not to relax.

If you’re booking a hotel room with your girlfriend, of course you’d want a comfy big bed.

“How’s he doing?”

Director Shang walked to the bedside to check with the patient’s wife.

“Thank you for all you did. My husband’s doing okay, pretty much the same as usual. I’m so grateful you and the team admitted him this quickly.”

She was remarkably polite.

She thanked Director Shang sincerely.

Director Shang himself coming with four young doctors to check on her husband felt like a huge honor.

“You came all the way from another province. It couldn’t have been easy. As doctors, we’ll always help when we can.”

After a few words, Director Shang got down to business.

“After you left earlier, we talked over your husband’s case again. Given his high eosinophil count and constant head-scratching, we suspect a parasitic infection. If you agree, I’ll order a head CT to see if we can pinpoint the culprit.”

The woman froze for a second, then smiled with relief.

“Yes, of course! I brought my husband here because I trust you and the hospital. Thank you for caring so much and working so hard for us!”

She bowed to Director Shang and Zhou Can, deeply grateful.

She glanced at Zhou Can, her eyes full of appreciation.

With her sharp mind and worldly experience, she could easily tell that Zhou Can was key to getting a quick diagnosis.

She remembered him asking about the head-scratching right before they left.

She also recalled him scrutinizing the right side of her husband’s head.

Now, the doctors’ reasoning focused on the fact that her husband kept scratching his head.

Once the scan was ordered, she paid the fee through her phone.

Zhou Can and the group helped transfer the patient to the CT room.

While the woman waited outside, Director Shang led Zhou Can and the others in to watch the real-time scan.

Attending physician Dr. Huang Xinggui came along too, eager to learn.

It was a rare chance to practice diagnosing a tough case.

At first, nothing unusual showed up. Minute by minute, time passed.

With so many people crowded together soaking up radiation, there would be plenty of laughs from other departments if they came up empty-handed.

Outside the CT room, the patient’s wife waited anxiously.

She was praying for a miracle.

For more than a year, she’d carried the weight of the family on her shoulders. Every single day had been an uphill struggle, and she constantly dreamed that something amazing would happen.

“It moved! There—look! Something’s wriggling in that spot!”

Luo Jingyin’s sharp eyes were the first to spot a strange movement in the patient’s brain scan.

After twitching a couple of times, the thing stilled.

“Unbelievable, it really is a parasite. Too sneaky, though. It barely moves, and if it sits still during the scan or hides in a hard-to-see spot, you could totally miss it. At least now we can give the family a real answer. Watching a woman in her thirties drag her husband from hospital to hospital is honestly heartbreaking.”

Director Shang spoke from the heart.

It wasn’t just him—Zhou Can, Xie Lin and the others felt the same.

Unfortunately, everyone is just human. All you can do is feel it inside. No one could find the cause, much less cure the patient.

The heavy CT room doors opened. Zhou Can and the group wheeled the patient out, triumphant smiles on their faces.

At last, the root of the problem had been found.

Now there was real hope.

“Doctor, did you find anything?”

The patient’s wife hurried over, hopeful and nervous.

“Good things come to those who wait. Congratulations, it looks like there’s a very high chance your husband has a parasite, based on the scan. But we can’t be completely certain until surgery removes the foreign object and a biopsy confirms what it is.”

Director Shang explained.

Normally, medications have little effect against sparganosis.

The standard treatment is surgical removal of the parasite, followed by an injection of medication at the site to prevent recurrence.

You could see just how cautious veteran doctors are—everyone knows what it is, but Director Shang wouldn’t spell it out.

Because the diagnosis isn’t confirmed, he only said it was “possibly” a parasitic infection.

Not a single firm word.

That kind of tact also spares the emotions of the patient’s loved ones.

Definitely something for younger doctors to learn.

“This is fantastic! I knew something good would happen at Tuyu. My sixth sense was right! Professor Shang, is it possible to get my husband into surgery right now?”

She wanted nothing more than for his illness to be cured at once.

“Hmm… not right away. We’re the gastroenterology department; we can’t perform this surgery ourselves. It’ll require neurosurgery or general surgery to work with us. Plus, we need anesthesiology consults, risk assessments, all that. Even getting it scheduled by tomorrow would be very fast.”

Director Shang patiently explained.

He understood how anxious the family must be.

But a hospital is a hospital, and cases that require teams from multiple departments can’t be rushed. Director Shang would do all he could to coordinate.

Doctors in neurosurgery are famously proud—they’re not exactly easy to win over.