Trichinosis

Trichinosis

Trichinosis is a tissue helminthiasis (nematodosis) that occurs with polymorphic symptoms due to different localization of the parasite. Etiology. Pathogens – small viviparous nematodes Trichinella spiralis (the main pathogen) and Trichinella nativa

• • The length of the male is 1.2 mm, the female before fertilization is 1.5–2.2 mm, after fertilization is 3.0–4.4 mm. The eggs develop in the uterus of the female, the larvae are found after 3-6 weeks after fertilization. Epidemiology. The disease is widespread everywhere, except for Asian countries and Australia. The circulation of parasites among a wide variety of wild and domestic animals (more than 45 species) occurs when eating each other. Most carnivores are infected with Trichinella spiralis. The greatest danger to humans is the consumption of improperly cooked meat of pork, bear, badger, nutria, sea pinnipeds and horse meat. Sexually mature individuals live in the intestines of the host (life span – 42-55 days). Born larvae (young forms) penetrate into the lymphatic capillaries and then into the bloodstream. Then the larva penetrates under the sarcolemma of the skeletal muscle and twists in a spiral (muscular form), after 3-4 weeks a connective tissue capsule 0.2-0.6 mm in size appears within it. Over time, the capsule thickens and calcifies. The larvae remain viable for many years (up to 40-50).

Clinical picture

• • Incubation period – 1-35 days (usually 10-25 days)
  • An increase in body temperature up to 38-41 ° C, abdominal pain, diarrhea and vomiting are noted.
  • The main disease develops as a result of the penetration of larvae into the muscles
  • Symptoms: fever, fatigue, muscle pain (usually cervical, calf and lumbar), swelling of the eyelids, skin rash, petechial rash on the conjunctiva and under the nails.

Research methods

• • Blood test: eosinophilia
  • Serological methods. For earlier diagnosis, the uroprecipitation reaction is used.
  • Identification of the pathogen in the muscle biopsy material (effective for 3 weeks of the disease).

Differential Diagnosis

• • Rheumatism
  • Arthritis
  • collagenoses
  • Encephalitis
  • Dermatomyositis
  • Gastroenteritis
  • Flu
  • glomerulonephritis
  • Myositis
  • Meningitis
  • Myocarditis
  • Pneumonia
  • Polyarteritis nodosa
  • Typhoid fever
  • Tuberculosis
  • Brucellosis.

Treatment

• • With severe muscle pain – analgesics (acetylsalicylic acid, codeine)
  • In severe allergic reactions – glucocorticoids (prednisolone 20-60 mg / day orally in several doses for 3-4 days with a gradual dose reduction and withdrawal within 10 days)
  • Mebendazole 200 mg 3 times a day for 3 days, then 400-500 mg 3 times a day for 10 days.

Complications

• • Lung infiltrates with hemoptysis
  • Heart failure
  • CNS damage: psychotic states, paresis, coma.

Current and forecast. The course varies from asymptomatic to severe. Mortality reaches 1% with moderate lesions and up to 10% with CNS lesions. Unfavorable signs are the absence of an eosinophilic reaction and a sudden decrease in the content of eosinophils to 1% or zero in the acute period of the disease. Prevention. Compliance with the rules of personal hygiene. Thorough heat treatment of meat (at least at a temperature of 56 ° C for 5 minutes). Synonym. Trichinosis ICD. B75 Trichinosis