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Thursday, April 7, 2011

TRICHNELLA SPIRALIS

This parasite of rats and pigs is transmitted to man by eating partially cooked infected pork
, usually as sausage or ham. Symptoms result from invasion of the body by larvae produced by the adult female worm in the small intestine and from their encystment in striated muscles. Outbreaks have occurred in Britain as well as in other countries where pork is eaten. Polar bear meat is another source.
Clinical features
The clinical features of trichinosis depends largely on the number of larvae. There may be no symptoms if there are only a few worms present, but many worms may cause nausea and diarrhoea 24-48 hours after the infected meal. Soon, however, these symptoms are overshadowed by those associated with the larval invasion , namely fever and oedema of the face, eyelids and conjunctivae. Invasion of the diaphragm may cause pain, cough and dyspnoea; involvement of the muscles of the limbs, chest and mouth causes stiffness, pain and tenderness in the affected muscle groups. Pyrexia may reach 40 degree C with daily remissions. Larval migration may cause acute myocarditis and encephalitis. An eosinophilia is usually found after the second week. An intense infection may prove fatal but those who survive recover completely.
Diagnosis
It is not uncommon for a group pf persons who have eaten infected pork from a common source to develop symptoms about the same time. Biopsy from the deltoid or gastrocnemius after the third week of symptoms in suspected cases may reveal encysted larvae, Serological tests, If available, are also helpful.
Management
Thiabendazole, 25 mg/kg b.d.for 2 days may relieve muscle pain. given early in the infection it may kill adult worms in the gut. Corticosteroids are given to control the serious effects of acute inflammation.

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