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==Natural History==
==Natural History==
*The [[symptoms]] vary depending on the phase, species of [[Trichinella]], amount of encysted larvae ingested, [[age]], gender, and host immunity.
*Trichinosis is usually self-limited, and the majority of individuals with trichinosis are asymptomatic.
*The [[symptoms]] vary depending on the phase, species of [[Trichinella|''Trichinella'']], amount of encysted larvae ingested, [[age]], gender, and host immunity.
*Patients infected by 10 or less larvae have either minor or no [[symptoms]] and no [[complications]].
*Patients infected by 10 or less larvae have either minor or no [[symptoms]] and no [[complications]].
*''Enteral/Intestinal phase'':
 
=== ''Enteral/Intestinal phase:'' ===
**From two to seven days after [[infection]].
**From two to seven days after [[infection]].
**The large burden of adult worms in the [[intestines]] promote [[symptoms]] such as [[nausea]], [[heartburn]], [[dyspepsia]], and [[diarrhea]].
**The large burden of adult worms in the [[intestines]] promote [[symptoms]] such as [[nausea]], [[heartburn]], [[dyspepsia]], and [[diarrhea]].
*''Parenteral/muscle phase'':
**Seven days after [[infection]].
**The severity of [[symptoms]] caused by larval migration from the [[intestines]] depends on the number of larvae produced.
**As the larvae migrate through [[tissue]] and [[vessels]], the body's inflammatory response results in: [[edema]], [[muscle pain]], [[fever]], and [[Weakness (medical)|weakness]].
**A classic sign of trichinosis is [[periorbital edema]], [[Periorbital edema|swelling around the eyes]], which may be caused by [[vasculitis]].
**[[Splinter hemorrhage]] in the nails is also a common symptom.
**If left untreated, the worms may cause enough damage to produce serious [[Neurological disorders|neurological deficits]] (such as [[ataxia]] or respiratory paralysis) from worms entering the [[central nervous system]] (CNS).
**The [[CNS]] is compromised by trichinosis in 10–24% of reported cases of [[cerebral venous sinus thrombosis]], a very rare form of [[stroke]] (3-4 cases per million annual incidence in adults).
**Trichinosis can be fatal depending on the severity of the [[infection]]; death can occur 4–6 weeks after the [[infection]], and is usually caused by [[myocarditis]], [[encephalitis]], or [[pneumonia]].<ref name="wiki1234">Trichinosis. Wikipedia. https://en.wikipedia.org/wiki/Trichinosis. Accessed on January 22, 2016</ref><ref name="pmid19136437">{{cite journal| author=Gottstein B, Pozio E, Nöckler K| title=Epidemiology, diagnosis, treatment, and control of trichinellosis. | journal=Clin Microbiol Rev | year= 2009 | volume= 22 | issue= 1 | pages= 127-45, Table of Contents | pmid=19136437 | doi=10.1128/CMR.00026-08 | pmc=PMC2620635 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19136437  }} </ref>


=== ''Parenteral/muscle phase:'' ===
*The parental phase starts approximately seven days after [[infection]].
*The severity of [[symptoms]] caused by larval migration from the [[intestines]] depends on the number of larvae produced.
*As the larvae migrate through [[tissue]] and [[vessels]], the body's inflammatory response results in [[edema]], [[muscle pain]], [[fever]], and [[Weakness (medical)|weakness]].
*A classic sign of trichinosis is [[periorbital edema]], [[Periorbital edema|swelling around the eyes]], which may be caused by [[vasculitis]].
*If left untreated, the worms may cause enough damage to produce serious [[Neurological disorders|neurological deficits]] (such as [[ataxia]] or respiratory paralysis) from worms entering the [[central nervous system]] (CNS).
*The [[CNS]] is compromised by trichinosis in 10–24% of reported cases of [[cerebral venous sinus thrombosis]], a very rare form of [[stroke]] (3-4 cases per million annual incidence in adults).
*Trichinosis can be fatal depending on the severity of the [[infection]]. Death can occur 4–6 weeks after the [[infection]], and is usually caused by [[myocarditis]], [[encephalitis]], or [[pneumonia]].<ref name="wiki1234">Trichinosis. Wikipedia. https://en.wikipedia.org/wiki/Trichinosis. Accessed on January 22, 2016</ref><ref name="pmid19136437">{{cite journal| author=Gottstein B, Pozio E, Nöckler K| title=Epidemiology, diagnosis, treatment, and control of trichinellosis. | journal=Clin Microbiol Rev | year= 2009 | volume= 22 | issue= 1 | pages= 127-45, Table of Contents | pmid=19136437 | doi=10.1128/CMR.00026-08 | pmc=PMC2620635 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19136437  }} </ref>
==Complications==
==Complications==
Common [[complications]] of trichinosis include:
Common complications of trichinosis include:
*[[Cardiovascular]]:
 
=== Cardiovascular: ===
** [[Heart failure]]
** [[Heart failure]]
** [[Heart rhythm]] problems ([[arrhythmias]]) from heart inflammation ([[myocarditis]])
** [[Heart rhythm]] problems ([[arrhythmias]]) from heart inflammation ([[myocarditis]])
Line 33: Line 35:
**[[Paroxysmal tachycardia]]
**[[Paroxysmal tachycardia]]
**[[Pericardial effusion]]
**[[Pericardial effusion]]
*[[Neurological|Neurological:]]
 
=== Neurological: ===
**[[Encephalomyelitis]]
**[[Encephalomyelitis]]
**[[Neuromuscular disorder|Neuromuscular disturbances]]:
**[[Neuromuscular disorder|Neuromuscular disturbances]]:
Line 55: Line 58:
**Prolonged [[diarrhoea]]<ref name="abc">FAO/WHO/OIE Guidelines for the surveillance, management, prevention and control of trichinellosis. FAO (2007). http://www.fao.org/documents/card/en/c/61e00fb1-87e8-5b89-8be1-50481e43eed1/ Accessed on January 28, 2016  </ref>
**Prolonged [[diarrhoea]]<ref name="abc">FAO/WHO/OIE Guidelines for the surveillance, management, prevention and control of trichinellosis. FAO (2007). http://www.fao.org/documents/card/en/c/61e00fb1-87e8-5b89-8be1-50481e43eed1/ Accessed on January 28, 2016  </ref>


===Prognosis===
==Prognosis==
*Most people with trichinosis have no [[symptoms]] and the [[infection]] goes away by itself. More severe [[infections]] may be more difficult to treat, especially if the [[lungs]], the [[heart]], or the [[brain]] is involved.<ref name="bb">Trichinosis. MedlinePlus. https://www.nlm.nih.gov/medlineplus/ency/article/000631.htm Accessed on January 28, 2016  </ref>
*


==References==
==References==

Revision as of 21:35, 5 February 2016

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

Overview

If left untreated, patients with trichinosis may progress to develop periorbital edema, muscle pain, and fever.[1][2] Complications of trichinosis affect the cardiovascular, neurological, ocular, respiratory and digestive systems.[3] Most people with trichinosis have no symptoms, the infection goes away by itself. The prognosis of trichinosis is good with treatment.[4] The most dangerous case is worms entering the central nervous system. They cannot survive there, but they may cause enough damage to produce serious neurological deficits (such as ataxia or respiratory paralysis), and even death. Infestation of the heart may also lead to death.[1]

Natural History

  • Trichinosis is usually self-limited, and the majority of individuals with trichinosis are asymptomatic.
  • The symptoms vary depending on the phase, species of Trichinella, amount of encysted larvae ingested, age, gender, and host immunity.
  • Patients infected by 10 or less larvae have either minor or no symptoms and no complications.

Enteral/Intestinal phase:

Parenteral/muscle phase:

Complications

Common complications of trichinosis include:

Cardiovascular:

Neurological:

Prognosis

References

  1. ↑ 1.0 1.1 1.2 Trichinosis. Wikipedia. https://en.wikipedia.org/wiki/Trichinosis. Accessed on January 22, 2016
  2. ↑ 2.0 2.1 Gottstein B, Pozio E, Nöckler K (2009). "Epidemiology, diagnosis, treatment, and control of trichinellosis". Clin Microbiol Rev. 22 (1): 127–45, Table of Contents. doi:10.1128/CMR.00026-08. PMC 2620635. PMID 19136437.
  3. ↑ 3.0 3.1 FAO/WHO/OIE Guidelines for the surveillance, management, prevention and control of trichinellosis. FAO (2007). http://www.fao.org/documents/card/en/c/61e00fb1-87e8-5b89-8be1-50481e43eed1/ Accessed on January 28, 2016
  4. ↑ Trichinosis. MedlinePlus. https://www.nlm.nih.gov/medlineplus/ency/article/000631.htm Accessed on January 28, 2016

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