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You Be the Doctor

An ultra-marathoner brings home a microscopic parasite. Can you identify this deadly amoeba?
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CHRISTIAN GRIFFITH, 44, IS AN ULTRA-MARATHONER FROM ATLANTA WHO REGULARLY COMPETES IN 50- TO 100- MILE RACES AROUND THE WORLD. So the Georgia marathon, at a more standard 26 miles, should have been a breeze. But he felt horrible afterward, with severe stomach pain, headache, and a low-grade fever.

The next day, Griffith experienced chest pain and had trouble breathing. He feared he was having a heart attack and went to the ER. Doctors made an initial diagnosis of pleurisy, an inflammation of the lining that surrounds the lungs often caused by the flu, and prescribed ibuprofen, but he got no better.

He started having night sweats and his temperature rose to 104. Griffith went to Emory Saint Joseph’s Hospital, which ran a battery of tests.

Infectious disease physician Mitchell Blass was called in to consult and discovered that Griffith’s left lower abdomen was tender. Blass ordered a CT scan of the area, which showed a mass on his liver as large as a softball.

“It was the largest I’ve seen in my career and was potentially life-threatening for him,” says Blass, a 1992 alumnus of Emory’s School of Medicine who completed his residency and fellowship in infectious disease at Emory.

Doctors treated Griffith with broad-spectrum antibiotics, but the mass continued to grow at an alarming rate. The next morning, a follow-up X-ray showed the mass had increased from 8 cm to 14 cm.

Any ideas, careful reader, what the mysterious mass might be?

Well, its rapid growth was Blass’s first clue that the growth was probably an abscess or infection caused by a parasite: in this case, Entamoeba histolytica, the second deadliest parasite in the world next to malaria. About 100,000 people die each year from these parasitic protozoa, which exist in water, soil, and food.

The infection can by asymptomatic (many who have the parasite don’t even realize it) or can lead to amoebic dysentery or a liver abscess, as in Griffith’s case. His mass, in fact, was in imminent danger of rupturing, so doctors performed emergency surgery. As a catheter drained fluid from his liver, his fever broke.

Griffith believes he got the parasite, which thrives in tropical climates, during a race in Nicaragua.

He and Blass were featured on a recent episode of the Animal Planet television program Monsters Inside Me, a series that tells the real-life dramas of people infected by unusual parasites and the doctors that save their lives.

“The experience taught me to follow what I believe to be my own path in life,” says Griffith. “No fear. No regrets.”

To watch the Monsters Inside Me episode: liveforaliving.com/living-blog/christian-griffith-monsters-inside-me

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