Love can make you feel tingly all over. But it shouldn’t give you “tingly throat syndrome.” If you have the latter, see a doctor.

The July issue of the American Journal of Tropical Medicine and Hygiene included a case report about a 25-year-old woman who had eaten some sashimi. Now the case report didn’t end there because “woman ate sashimi, and it was yummy,” doesn’t usually qualify as a medical case report. No, something bad or at least unusual has to happen. Often, it is both. It is badunusual or unusubad.

After the sashimi fest, this woman then proceeded to have five days of pain and irritation in her pharynx, which is a fancier way of saying the back of her throat. When she went to her doctor, a physical exam found something is her left tonsil. It wasn’t just her tonsil, and it wasn’t love.

It was a black moving worm. If you haven’t figured it out yet, you aren’t supposed to have a worm in your tonsil, let alone a moving worm. This one was 38 mm long (which is about 1.5 inches) and one mm wide, which is 38 mm longer than a worm should be. Oh, it was molting (shedding its skin) as well.

Here’s a photo of the worm:

So what do you do when you see a moving worm in a person’s tonsil? Pluck it out of course. That’s what the doctor did with a pair of tweezers, and presto the patient’s symptoms soon improved rapidly.

It turns out this worm was a larval form of Pseudoterranova azarasi, a nematode in the Anisakidae family. This is not a good family to hang out with, given that they are parasites. A Centers for Disease Control and Prevention (CDC) website shows the Anisakiasis life cycle. Marine mammals such as dolphins and sea lions who have eaten infected fish can then poop out the parasite eggs into the ocean. These eggs hatch and the larvae swim around like Michael Phelps in the ocean until they are ingested by crustaceans. When fish eat infected crustaceans, they in turn get infected by the larvae. The larvae then burrow into the fish’s mesentary and muscles.

You can get involved in the act when you can eat raw or under-cooked fish that have these larvae. The larvae typically make their way down to your stomach or intestines. There they can cause inflammation or damage. You can also have allergic reactions to these worms.

Rarely, the larvae can stay in your throat area and that’s when you may develop “tingling throat syndrome” and potentially a cough.

How do you diagnose such a worm in your throat? You see such a worm in your throat. There isn’t a special test that you can take or a special “worm in throat” app that can tell you that you have such a worm in your throat.

Fortunately, this is not a common occurrence. So, no need to stare at your throat in the mirror wondering, “where’s the worm, where’s the worm?” However, make sure that the fish that eat is either well-cooked or from a reputable sushi place that takes the proper precautions such as freezing the sushi or sashimi before using it. After all, the only tingling that you should feel after eating sashimi is love.