Trichinosis natural history, complications, and prognosis

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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, infected patients develop manifestations within 1-2 days of infection. Infected 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 is usually self-limited. The prognosis of trichinosis is good with adequate treatment.[4]

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:[3]

Cardiovascular:

Neurological:

Ocular:

Respiratory:

Digestive:

Prognosis

  • The prognosis of trichinosis is good with adequate treatment.
  • Most people with trichinosis have no symptoms, the infection is usually self-limited.[4]
  • The mortality rate of trichinosis is approximately 0.2% worldwide.[5]
  • Prompt treatment with antiparasitic drugs can help prevent the progression of trichinellosis by killing the adult worms and so preventing further release of larvae.
  • Once the ''Trichinella'' larvae have become established in skeletal muscle cells, usually by 3 to 4 weeks post infection, treatment may not completely eliminate the infection and associated symptoms.
  • If trichinosis treatment is not initiated within the first several days of infection, more prolonged or repeated courses of treatment may be necessary.[6]

References

  1. 1.0 1.1 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.
  2. 2.0 2.1 Trichinosis. Wikipedia. https://en.wikipedia.org/wiki/Trichinosis. Accessed on January 22, 2016
  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. 4.0 4.1 Trichinosis. MedlinePlus. https://www.nlm.nih.gov/medlineplus/ency/article/000631.htm Accessed on January 28, 2016
  5. Pozio E (2007). "World distribution of Trichinella spp. infections in animals and humans". Vet Parasitol. 149 (1–2): 3–21. doi:10.1016/j.vetpar.2007.07.002. PMID 17689195.
  6. Trichinellosis. CDC. http://www.cdc.gov/parasites/trichinellosis/health_professionals/index.html#tx. Accessed on January 26, 2016