Intended for healthcare professionals

Endgames Spot Diagnosis

Even a worm can turn

BMJ 2015; 351 doi: (Published 08 October 2015) Cite this as: BMJ 2015;351:h5290
  1. Andrés F Henao-Martínez, assistant professor of medicine 1,
  2. Nancy Madinger, associate professor of medicine and pathology1
  1. 1Division of Infectious Diseases, Department of Medicine, University of Colorado Denver, Aurora, CO 80045, USA
  1. Correspondence to: A F Henao-Martínez andres.henaomartinez{at}

A previously fit and well 24 year old US born white man presented for evaluation of abdominal pain. He had felt tired for the past two days and had been experiencing headaches, subjective fevers, and diffuse abdominal pain. Despite this he had maintained a good appetite and his normal diet, which included eating sushi at least once a week. His symptoms improved greatly after he noted a tape-like object in his stool. He had travelled to California, …

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