Trichinosis

Introduction

-Trichinosis is a parasitic disease caused by Trichinella spiralis and related species 

-it is the most common parasite of skeletal muscle

-it is spread by ingestion of undercooked meat, most commonly pork 

-Life cycle: Humans ingest undercooked meat containing encysted larvae, which mature into adults in the intestine. Female worms release larvae which enter blood and migrate to skeletal muscle or other organs, where they encyst

Symptoms & Signs 

-Most infections are asymptomatic

-Infection can be divided into two phases: 

Intestinal phase: fever, headache, chills, abdominal pain, nausea, vomiting, and diarrhea 

Muscular phase: Fever, facial edema, eyelid or periorbital edema, myalgia, weakness, maculopapular exanthem, subungual bleeding, conjunctivitis and subconjunctival hemorrhages, retinal hemorrhages, dry cough, dyspnea, dysphagia, painful movement of the eye muscles, involuntary movements, myocarditis, thromboembolic disease, and encephalitis

Diagnosis 

Labs: Eosinophilic leukocytosis, elevated serum muscle enzymes (creatine kinase, lactate dehydrogenase, aspartate aminotransferase), normal ESR 

-ELISA, serologic tests, muscle biopsy showing encysted larvae 

Treatment 

Albendazole is the drug of choice for trichinosis; Mebendazole