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.^[1]

**Differentiating Trichinosis from other Diseases**^[1]
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

↑ ^1.0 ^1.1 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