Last August, a young man walked into the emergency room with an unusual demand.
"He asked me for worm treatment and I was like, 'Oh, not an everyday request,'" said UCSF Fresno Emergency Medicine Physician Dr. Kenny Banh.
Banh is usually skeptical of patients who self-diagnose but in this case, the man was adamant about his symptoms.
It began with a trip to the bathroom, some bloody diarrhea, and the realization that something was dangling from his rectum.
"And he thinks it's very odd," Banh explained. "He doesn't get it until he pulls it out, and then it wiggles and he drops it and is like, 'Oh. It's a worm.'"
A tapeworm measuring 5-1/2 feet long.
The man brought the parasite with him to the hospital, wrapped around an empty toilet paper roll, along with a hypothesis.
"He says the one thing I like, that I love, I love sushi, specifically salmon sashimi and I eat it every day," said Banh.
He says raw fish is a reasonable cause for an infestation. The tapeworm had likely been growing in the man's intestines for at least six months.
Last year, the CDC put out an alert warning about parasites found in Alaskan caught salmon.
"What does everyone want to know? 'When did I get, where did I get it from,' he wants me to go all WebMD on him," said Banh.
Questions also arose if the tapeworm helped the man lose any weight.
"Everybody asks me that," said Banh. "And the answer is absolutely not he's like all the negatives of the worm infestation and none of the positives."
Banh said ingesting worms is not the way to lose weight.
In this case, the man visited too many local sushi restaurants to pinpoint where he may have gotten the infestation.
He did tell physicians as he left, he would never eat sashimi again.