Trichinellosis/Trichinosis Follow-up

Updated: Nov 06, 2015
  • Author: L Kristian Arnold, MD, MPH; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Follow-up

Further Outpatient Care

In suspected cases that do not require admission, ensure early follow-up for continued monitoring.

In suspected cases, arrange for surgical follow-up care in 1-2 days for muscle biopsy.

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Further Inpatient Care

Admit patients with neurologic or cardiac symptoms for initiation of therapy.

Consider patients with significant diffuse muscle involvement for hospitalization because they are at risk for Jarisch-Herxheimer-like reactions.

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Deterrence/Prevention

Adequate cooking of all meat products is the primary deterrent to acquiring infection with the Trichinella species.

Adequate cooking refers to the point at which no red meat remains.

The US Code of Federal Regulations and the US Department of Agriculture have information regarding preparation of pork and appropriate times and temperatures needed to kill larvae. For cooking, pork must reach an internal temperature of 160°F (71°C); for freezing, it must remain at 5°F (-15°C) for 3 weeks. [19]

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Complications

Potential complications of trichinellosis/trichinosis include the following:

  • Meningitis
  • Subcortical infarcts
  • Encephalitis
  • Myocarditis with congestive heart failure
  • Nephritis
  • Glomerulonephritis
  • Sinusitis
  • Pneumonia
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Prognosis

Recovery with resolution of signs and symptoms may occur in 5-6 weeks after infestation in many patients with disease limited to enteropathic and mild muscular involvement.

More than 50% of patients with disease that progresses only to muscle involvement may experience varying degrees of persistent fatigue and myalgia despite a full course of anthelminthic treatment. Patients infected with nonencapsulating species tend to have less muscle pain, although this pain is more persistent. Nurse cells in encapsulated species tend to eventually calcify, resulting in destruction of the larva and resolution of the painful inflammation, although live larvae have been documented in lesions many years after initial infestation.

Patients with CNS, cardiac, or renal involvement may have protracted courses with persistent stiffness, neurologic disorders, and heart or kidney dysfunction.

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