Trichinosis differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Danitza Lukac

Overview

Trichinosis must be differentiated from influenza virus, salmonella, shigella, eosinophilia-myalgia syndromes, tissular parasitosis, glomerulonephritis, serum sickness, infectious meningitis and encephalitis, leptospirosis, bacterial endocarditis and typhus exanthematicus.

Differentiating Trichinosis from other Diseases

Differentiating Trichinosis from other Diseases

Differential Diagnosis	Similar Clinical Features	Distinguishing Clinical Features
Influenza virus	High fever + myalgia	No eosinophilia
Salmonella Shigella	Protracted diarrhoea	No eosinophilia
Eosinophilia-Myalgia Syndromes: Toxic Oil Syndrome Tryptophan Intake Eosinophilic Fasciitis	Eosinophilia + myalgia + inflammatory response	History of L-tryptophan ingestion
Fascioliasis Toxocariasis Invasive Schistosomiasis	Eosinophilia + fever	Fascioliasis: Latent phase after symptoms start Toxocariasis: Elevation of anti-A, anti–B isohaemagglutinins Invasive Schistosomiasis: Itchy + papular rash
Glomerulonephritis Serum Sickness Allergic reactions to drugs or allergens Polymyositis Dermatomyositis Periarteritis Nodosa	Periorbital or facial edema + fever	Glomerulonephritis: Hematuria + foamy urine Serum Sickness: Due to an antiserum derived from an animal source Polymyositis: Weakness and/or loss of muscle mass in the proximal musculature + dysphagia + foot drop Dermatomyositis: Symmetric proximal muscle weakness + Gottron's sign + heliotrope + Shawl (or V-) sign + Erythroderma Periarteritis Nodosa: Nodules in the lower legs + nerve involvement (numbness, pain, burning, and weakness) + Livedo reticularis
Leptospirosis Bacterial Endocarditis	Haemorrhages of the conjunctiva or haemorrhagic skin petechiae + fever	Leptospirosis: Jaundice + asymptomatic phase (3–4 days) after symptoms start Bacterial Endocarditis: Osler nodes, Janeway lesion