Trichinosis natural history, complications, and prognosis: Difference between revisions

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==Overview==
==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]].<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> <ref name="wiki1234">Trichinosis. Wikipedia. https://en.wikipedia.org/wiki/Trichinosis. Accessed on January 22, 2016</ref> [[Complications]] of trichinosis affect the [[cardiovascular]], [[neurological]], [[ocular]], [[respiratory|respiratory,]] and [[Digestive system|digestive systems]].<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> Most people with trichinosis have no [[symptoms]], the [[infection]] is usually self-limited. The [[prognosis]] of trichinosis is good with adequate treatment.<ref name="bb">Trichinosis. MedlinePlus. https://www.nlm.nih.gov/medlineplus/ency/article/000631.htm Accessed on January 28, 2016  </ref>  
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]].<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><ref name="wiki1234">Trichinosis. Wikipedia. https://en.wikipedia.org/wiki/Trichinosis. Accessed on January 22, 2016</ref> Complications of trichinosis affect the [[cardiovascular]], [[neurological]], [[ocular]], [[respiratory|respiratory,]] and [[Digestive system|digestive systems]].<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> Most people with trichinosis have no symptoms, the infection is usually self-limited. The prognosis of trichinosis is good with adequate treatment.<ref name="bb">Trichinosis. MedlinePlus. https://www.nlm.nih.gov/medlineplus/ency/article/000631.htm Accessed on January 28, 2016  </ref>  


==Natural History==
==Natural History==
*Trichinosis is usually self-limited, and the majority of individuals with trichinosis are asymptomatic.
*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.
*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:'' ===
=== ''Parenteral/muscle phase:'' ===
*The parental phase starts approximately seven days after [[infection]].
*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.  
*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]].  
*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]].  
*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).  
*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).
*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>
*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="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><ref name="wiki1234">Trichinosis. Wikipedia. https://en.wikipedia.org/wiki/Trichinosis. Accessed on January 22, 2016</ref>
==Complications==
==Complications==
Common complications of trichinosis include:
Common complications of trichinosis include:
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***[[Dysphagia]]
***[[Dysphagia]]
***[[Trismus]]
***[[Trismus]]
*[[Ocular]]:
 
=== Ocular: ===
**[[Edema]] and [[Vascular anomaly|vascular lesions]] within the [[conjunctiva]], [[uvea]], [[retina]], and, in some cases, the [[optic nerve]]
**[[Edema]] and [[Vascular anomaly|vascular lesions]] within the [[conjunctiva]], [[uvea]], [[retina]], and, in some cases, the [[optic nerve]]
**Pain when moving the eyeballs
**Pain when moving the eyeballs
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**[[Diplopia]]
**[[Diplopia]]
**Disturbed [[Accommodation (eye)|accommodation]]
**Disturbed [[Accommodation (eye)|accommodation]]
*[[Respiratory]]:
 
=== Respiratory: ===
**[[Dyspnea]]
**[[Dyspnea]]
**[[Pneumonia]]
**[[Pneumonia]]
**Obstructive [[bronchitis]]
**Obstructive [[bronchitis]]
**Löffler-type infiltrates or ventilature failures
**Löffler-type infiltrates or ventilature failures
*[[Digestive]]:
 
=== Digestive: ===
**[[Hypoalbuminemia]]
**[[Hypoalbuminemia]]
**Acute [[intestinal]] [[necrosis]]  
**Acute [[intestinal]] [[necrosis]]  

Revision as of 15:09, 8 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, 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:

Cardiovascular:

Neurological:

Ocular:

Respiratory:

Digestive:

Prognosis

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. Trichinosis. MedlinePlus. https://www.nlm.nih.gov/medlineplus/ency/article/000631.htm Accessed on January 28, 2016

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