Shit I have to play this

I got you fam. From the case write up:

In June 2022, she underwent an open biopsy. We noted a stringlike structure within the lesion, which we removed; it was a live and motile helminth (80 mm long, 1 mm diameter) (Figure 2, panels B, C). We performed a circumferential durotomy and corticotomy and found no other helminths. Histopathology of the dural tissue revealed a benign, organizing inflammatory cavity with prominent eosinophilia.

We provisionally identified the helminth as a third-stage larva of Ophidascaris robertsi on the basis of its distinctive red color, 3 active ascaridoid-like lips, presence of a cecum, and absence of a fully developed reproductive system, in the context of the known epidemiologic distribution of this species. The head and tail were preserved at the Australian National Wildlife Collection (W/LHC no. N5758). Small segments underwent independent PCR-based sequencing targeting the cytochrome oxidase c subunit 1 (cox1) (5,6) at the University of Sydney and the second internal transcribed spacer (ITS) 2 of nuclear ribosomal DNA (7) at the University of Melbourne. Both sequencing results provided >99.7% sequence match to Ophidascaris (formerly Amplicecum) robertsi isolates in the National Center for Biotechnology Information and in-house databases (Appendix).

A progress CT scan revealed resolution of pulmonary and hepatic lesions but unchanged splenic lesions. The patient received 2 days of ivermectin (200 µg/kg/d) and 4 weeks of albendazole (400 mg 2×/d). She was given a weaning course of dexamethasone (starting 4 mg 2×/d) over 10 weeks, while all other immunosuppression was discontinued. Six months after surgery (3 months after ceasing dexamethasone), the patient’s PBEC remained normal. Neuropsychiatric symptoms had improved but persisted.

And this bit from the conclusion:

After we removed the larva from her brain, the patient received anthelmintics and dexamethasone to address potential larvae in other organs. Ophidascaris larvae are known to survive for long periods in animal hosts; for example, laboratory rats have remained infected with third-stage larvae for >4 years (4). The rationale for ivermectin and albendazole was based on data from the treatment of nematode infections in snakes and humans (8,9). Albendazole has better penetration into the CNS than ivermectin (10). Dexamethasone has been used in other human nematode and tapeworm infections to avoid deleterious inflammatory CNS responses following treatment (11).