It was a fairly regular day on the ward for Canberra hospital infectious diseases physician Dr Sanjaya Senanayake, until a neurosurgeon colleague called him and said: “Oh my god, you wouldn’t believe what I just found in this lady’s brain – and it’s alive and wriggling.”

The neurosurgeon, Dr Hari Priya Bandi, had pulled an 8cm-long parasitic roundworm from her patient, prompting her to call on Senanayake and other hospital colleagues for advice about what to do next.

The patient, a 64-year-old woman from south-eastern New South Wales, was first admitted to her local hospital in late January 2021 after suffering three weeks of abdominal pain and diarrhoea, followed by a constant dry cough, fever and night sweats.

The surprising discovery prompted a team at the hospital to quickly come together to uncover what kind of roundworm it was and, most importantly, decide on any further treatment the patient might require.

Senanayake, who is also an infectious diseases expert based at the Australian National University, said the patient needed to be treated for other larvae that might have invaded other parts of her body, such as the liver.

The patient is recovering well and is still being regularly monitored, Senanayake said, and researchers are exploring whether a pre-existing medical condition that caused her to be immunocompromised could have led to the larvae taking hold.

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