Trichinellosis is a term for a parasitic infection caused by Trichinella species, most notably Trichinella spiralis. This condition occurs in humans by ingestion of various meat products (mainly pork) that are contaminated with this parasite. The clinical presentation correlates with the amount of parasite ingested, ranging from asymptomatic and mild constitutional complaints to severe myalgia, urticaria, conjunctival hemorrhage, fever, hypoalbuminemia, and the development of life-threatening complications. The diagnosis is made through serological testing and a thorough patient history that identifies recent consumption of "suspicious" meat products.
Presentation
Trichinellosis denotes an infection by the tissue nematode Trichinella, with many discovered species [1] [2] [3]. The vast majority of human cases, however, are caused by Trichinella spiralis, which is found in many parts of the world [1] [2] [3] [4]. The pathogenesis of this zoonotic disease starts by the consumption of the parasite through contaminated or undercooked meat products and animals that have been confirmed as the source of T. spiralis - pigs, horses, wild boars, and even dogs in certain geographic areas [1] [2] [4] [5]. The clinical course strongly depends on the quantity of parasite introduced into the organism, with an average incubation period around 1-3 weeks [1] [2]. In milder cases, the presentation may be asymptomatic or consist of few constitutional symptoms - myalgia, low-grade fever, and gastrointestinal discomfort. When a substantial parasitic load has occurred, symptoms in the form of diarrhea, nausea, vomiting, headache, and severe myalgia characterize trichinellosis and appear within days [1] [2] [6]. As the parasite attempts to migrate from the gastrointestinal tract into other tissues several weeks after the initial infection, a prominent immunological reaction develops, inducing a more prominent clinical response - high-grade fever accompanied by chills, swelling, periorbital edema, urticarial rash, conjunctival hemorrhage, and myalgia as a constitutive feature [2] [6]. Furthermore, various complications have been reported, including myocarditis, encephalitis, and thromboembolic disease, which may be life-threatening in the absence of proper therapy [1] [2] [4] [5] [6].
Entire Body System
- Fever
Physicians must be aware of trichinosis and should include it in their differential diagnosis when examining patients with fever and myositis with or without eosinophilia. [ncbi.nlm.nih.gov]
In milder cases, the presentation may be asymptomatic or consist of few constitutional symptoms - myalgia, low-grade fever, and gastrointestinal discomfort. [symptoma.com]
Signs and symptoms include abdominal discomfort, nausea, vomiting, fever, diarrhea, headache, coughing, myalgias, arthralgias, and eye swelling. An infection with trichinella. [icd9data.com]
The first symptoms of trichinellosis occur suddenly, and they include nausea, diarrhea, vomiting, fatigue, fever, and stomach ache. [gov.mb.ca]
- Hunting
The wild boar is an important source of trichinellosis for people in European countries as a large number of hunted animals escape veterinary control. [ncbi.nlm.nih.gov]
- Chills
These included fever with chills and myalgia (100%), periorbital oedema (67%), dyspnoea (9%), and dysphagia (3%). [ncbi.nlm.nih.gov]
[…] the parasite attempts to migrate from the gastrointestinal tract into other tissues several weeks after the initial infection, a prominent immunological reaction develops, inducing a more prominent clinical response - high-grade fever accompanied by chills [symptoma.com]
Headaches, fevers, chills, cough, eye swelling, aching joints and muscle pains, itchy skin, diarrhea, or constipation follow the first symptoms. [gov.mb.ca]
313 - 316 DOI: https://doi.org/10.4269/ajtmh.2009.81.313 Abstract Full-Text Figures & Tables References (15) Cited By Supplements Metrics Related Content Abstract We report the case of a 42-year-old woman who was admitted to the hospital for fever, chills [ajtmh.org]
- Fatigue
The first symptoms of trichinellosis occur suddenly, and they include nausea, diarrhea, vomiting, fatigue, fever, and stomach ache. [gov.mb.ca]
We report the case of a 42-year-old woman who was admitted to the hospital for fever, chills, nausea, vomiting, fatigue, myalgia, and general muscle weakness. [ncbi.nlm.nih.gov]
[…] doi.org/10.4269/ajtmh.2009.81.313 Abstract Full-Text Figures & Tables References (15) Cited By Supplements Metrics Related Content Abstract We report the case of a 42-year-old woman who was admitted to the hospital for fever, chills, nausea, vomiting, fatigue [ajtmh.org]
Symptoms may include: Nausea and vomiting Diarrhea Abdominal pain Fatigue Fever Headaches Fever Chills Cough Swelling in the face and eyes Muscle and joint pains Itchy skin Constipation Difficulty moving Breathing or heart problems Death, in severe cases [gethealthycarsoncity.org]
- Rigor
The evidence that the disease can be monitored and to some extent controlled with a rigorous reporting and testing system in place should be motivation to expand appropriate programs worldwide. [ncbi.nlm.nih.gov]
Gastrointestinal
- Nausea
Source:MedicineNet Nausea and Vomiting - Nausea and vomiting symptoms of many conditions including motion sickness, pregnancy, emotional stress, gallbladder disease, and more. [web.archive.org]
The symptoms of the disease vary widely depending on the infection load, stage of infection and host immunity and include nausea, vomiting, abdominal pain, fever, facial edema and muscle pain. [ncbi.nlm.nih.gov]
Signs and symptoms include abdominal discomfort, nausea, vomiting, fever, diarrhea, headache, coughing, myalgias, arthralgias, and eye swelling. An infection with trichinella. [icd9data.com]
- Vomiting
Source:MedicineNet Nausea and Vomiting - Nausea and vomiting symptoms of many conditions including motion sickness, pregnancy, emotional stress, gallbladder disease, and more. [web.archive.org]
The symptoms of the disease vary widely depending on the infection load, stage of infection and host immunity and include nausea, vomiting, abdominal pain, fever, facial edema and muscle pain. [ncbi.nlm.nih.gov]
Signs and symptoms include abdominal discomfort, nausea, vomiting, fever, diarrhea, headache, coughing, myalgias, arthralgias, and eye swelling. An infection with trichinella. [icd9data.com]
- Diarrhea
The first symptoms of trichinellosis occur suddenly, and they include nausea, diarrhea, vomiting, fatigue, fever, and stomach ache. [gov.mb.ca]
Signs and symptoms include abdominal discomfort, nausea, vomiting, fever, diarrhea, headache, coughing, myalgias, arthralgias, and eye swelling. An infection with trichinella. [icd9data.com]
» Diarrhea - Explains diarrhea (loose stool or frequent bowel movements) and includes causes, dehydration prevention and treatment. [web.archive.org]
The short incubation period (average of 9.5 days), the severity of the symptoms, which were characterized by diarrhea, abdominal pain, fever, myalgia, edema, weight loss, itch, and lisping, and the high mortality, suggest that patients had ingested a [ncbi.nlm.nih.gov]
- Abdominal Pain
Clinically the epidemic has shown a typical, uncomplicated febrile course in most patients, but two patients showed signs of cardiac damage and one intense abdominal pain, suggesting an acute abdomen. [ncbi.nlm.nih.gov]
Skin
- Urticaria
The clinical presentation correlates with the amount of parasite ingested, ranging from asymptomatic and mild constitutional complaints to severe myalgia, urticaria, conjunctival hemorrhage, fever, hypoalbuminemia, and the development of life-threatening [symptoma.com]
Eyes
- Periorbital Edema
We hereby discuss an atypical case of trichinellosis, which presented with myositis of the thigh muscles but had no eosinophilia and no facial or periorbital edema and was associated with osteomyelitis of the femur. [ncbi.nlm.nih.gov]
- Retinal Hemorrhage
Vitreous cells and retinal hemorrhage were observed in both eyes. In both cases, inflammation and retinal hemorrhage disappeared one month after first visit. Conclusion:Trichinellosis is one of the causes of uveitis and palpebral edema. [webview.isho.jp]
Musculoskeletal
- Myalgia
These included fever with chills and myalgia (100%), periorbital oedema (67%), dyspnoea (9%), and dysphagia (3%). [ncbi.nlm.nih.gov]
In milder cases, the presentation may be asymptomatic or consist of few constitutional symptoms - myalgia, low-grade fever, and gastrointestinal discomfort. [symptoma.com]
Signs and symptoms include abdominal discomfort, nausea, vomiting, fever, diarrhea, headache, coughing, myalgias, arthralgias, and eye swelling. An infection with trichinella. [icd9data.com]
- Arthralgia
Signs and symptoms include abdominal discomfort, nausea, vomiting, fever, diarrhea, headache, coughing, myalgias, arthralgias, and eye swelling. An infection with trichinella. [icd9data.com]
The most commonly observed signs and symptoms were myalgia (89.2%), arthralgia (69.9%) and eyelid (67%) and facial oedema (65.8%). [ncbi.nlm.nih.gov]
- Muscle Weakness
We report the case of a 42-year-old woman who was admitted to the hospital for fever, chills, nausea, vomiting, fatigue, myalgia, and general muscle weakness. [ncbi.nlm.nih.gov]
- Muscle Swelling
swelling and pain, weakness, and in some cases, skin rash and peripheral edema. [orpha.net]
Face, Head & Neck
- Facial Edema
The symptoms of the disease vary widely depending on the infection load, stage of infection and host immunity and include nausea, vomiting, abdominal pain, fever, facial edema and muscle pain. [ncbi.nlm.nih.gov]
Workup
Due to the nonspecific clinical presentation of trichinellosis, the diagnosis might be difficult to attain [1] [2] [4] [5] [6]. For this reason, a thorough patient history is often the crucial component of the workup. Physicians must ask the patients if they consumed undercooked or "suspicious" game meat, pork, or other meat products and determine if the timetable matches the clinical course [2]. A detailed physical examination should not be overlooked, as it may provide further clues toward trichinellosis as the cause of symptoms. But in order to make a definite diagnosis, both laboratory and specific microbiological studies need to be performed. A complete blood count (CBC) will almost always show marked eosinophilia, which is typical for a parasitic infection, whereas very high levels of serum creatine phosphokinase (CBK or CK) are highly indicative of trichinellosis in the presence of myalgia and eosinophilia [1] [2] [6]. Conversely, specific serology testing for the detection of T. spiralis antigens and respective antibodies through enzyme-linked immunosorbent assay (ELISA) is a reliable method that can confirm the presence of this parasite [1]. However, the test may be false-negative in the initial stages of the ailment, as antibodies are not yet formed against the pathogen [1] [3]. Although being highly invasive is not always recommended, a muscle biopsy can sometimes be carried out in order to obtain a viable sample of parasitological testing [1] [6].
Microbiology
- Trichinella Spiralis
Trichinellosis is a worldwide zoonotic disease caused by a nematode Trichinella spiralis. [ncbi.nlm.nih.gov]
From Wikidata Jump to navigation Jump to search parasitic disease due to invasion by Trichinella spp. trichiniasis Trichinella spp. invasion Trichinella spp. infection trichinellosis Trichinella spiralis infection Triquina edit English trichinosis parasitic [wikidata.org]
Other Pathologies
- Tissue Nematode
Trichinellosis denotes an infection by the tissue nematode Trichinella, with many discovered species. The vast majority of human cases, however, are caused by Trichinella spiralis, which is found in many parts of the world. [symptoma.com]
Treatment
If treatment is not initiated within the first several days of infection, more prolonged or repeated courses of treatment may be necessary. [web.archive.org]
Clinical symptoms resolved in all patients during albendazole treatment. The results suggest that only a proportion of the trichinellosis cases had sought health care during the outbreak. [ncbi.nlm.nih.gov]
Prognosis
What is the prognosis for patients with trichinosis? For those who have minor or no symptoms, the prognosis is excellent with no complications. [web.archive.org]
Etiology
All members of the trichinella genus can infect human in addition to trichinella spiralis, the traditional etiological agent. [icd9data.com]
Among their children, one died in utero at 26 weeks gestation due to maternal hepatitis of unknown etiology and a second child had Trichinella-specific IgG antibodies but was clinically normal. [ncbi.nlm.nih.gov]
[…] of diseases in human communities. 2. the field of medicine concerned with the determination of the specific causes of localized outbreaks of infection, such as hepatitis, of toxic disorders, such as lead poisoning, or any other disease of recognized etiology [vdh.virginia.gov]
Predominant age: 20 to 49 years, although cases were reported from all age groups Predominant sex: male = female Etiology and Pathophysiology Eating undercooked meat contaminated with viable Trichinella cysts. [unboundmedicine.com]
Epidemiology
epidemiological trends during the past 17 years (1990-2006) were determined. [ncbi.nlm.nih.gov]
Publication Trichinellosis - Annual Epidemiological Report for 2017 Publication Trichinellosis - Annual Epidemiological Report for 2016 Publication Trichinellosis - Annual Epidemiological Report for 2015 Publication Trichinellosis - Annual Epidemiological [ecdc.europa.eu]
Pathophysiology
Predominant age: 20 to 49 years, although cases were reported from all age groups Predominant sex: male = female Etiology and Pathophysiology Eating undercooked meat contaminated with viable Trichinella cysts. [unboundmedicine.com]
Prevention
Courtesy of Centers for Disease Control and Prevention (CDC) (https://www.cdc.gov/parasites/trichinellosis/resources/trichinellosis_surveillance_summary_2015.pdf). [emedicine.medscape.com]
Treatment Information Prompt treatment with antiparasitic drugs can help prevent the progression of trichinellosis by killing the adult worms and so preventing further release of larvae. [web.archive.org]
In response to these events, stakeholders set up the community-based Nunavik Trichinellosis Prevention Program (NTPP). [ncbi.nlm.nih.gov]
Prevention Cook food to safe temperatures. A food thermometer should be used to measure the internal temperature of cooked meat. Do not sample meat until it is cooked. [gov.mb.ca]
References
- Gottstein B, Pozio E, Nöckler K. Epidemiology, Diagnosis, Treatment, and Control of Trichinellosis. Clin Microbiol Rev. 2009;22(1):127-145.
- McIntyre L, Pollock SL, Fyfe M, et al. Trichinellosis from consumption of wild game meat. CMAJ. 2007;176(4):449-451.
- Wang Z-Q, Shi Y-L, Liu R-D, et al. New insights on serodiagnosis of trichinellosis during window period: early diagnostic antigens from Trichinella spiralis intestinal worms. Infect Dis Poverty. 2017;6:41.
- Ortega-Pierres MG, Arriaga C, Yépez-Mulia L. Epidemiology of trichinellosis in Mexico, Central and South America. Vet Parasitol. 2000;93(3-4):201-225.
- Holzbauer SM, Agger WA, Hall RL, et al. Outbreak of Trichinella spiralis infections associated with a wild boar hunted at a game farm in Iowa. Clin Infect Dis. 2014;59(12):1750-1756.
- Dupouy-Camet J, Kociecka W, Bruschi F, Bolas-Fernandez F, Pozio E. Opinion on the diagnosis and treatment of human trichinellosis. Expert Opin Pharmacother. 2002;3(8):1117-1130.