infectious diseases
Trichinosis
Key Points
Humans become infected withTrichinellaby eating raw, undercooked, or under-processed meat from infected animals—most commonly pigs, wild boar, or bear. Larvae excyst in the small bowel, penetrate the mucosa, and become adults that release living larvae; the larvae migrate through the bloodstream and lymphatics and encyst within striated skeletal muscle cells. Symptoms begin with gastrointestinal irritation followed by periorbital edema, muscle pain, fever, and eosinophilia. Manifestations gradually resolve by about the 3rd month, when the larvae have become fully encysted, although vague muscular pains and fatigue may persist. Diagnose using enzyme immunoassay. Treat symptoms (eg, with analgesics for pain andprednisonefor allergic manifestations or central nervous system [CNS] or myocardial involvement); anthelmintics kill adult worms, but once larvae encyst in skeletal muscle, treatment may not eradicate them or any associated symptoms. Thoroughly cooking meat from pigs and wild animals can prevent trichinosis. 