Materiały źródłowe

• #1 Trichinosis: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/7142-trichinosis

  Your healthcare provider might decide you have trichinosis on the basis of: […] Antibodies to Trichinella dont show up at first, but your provider might order blood tests later that will find the antibodies and confirm the diagnosis. Stool (poop) samples arent used to diagnose trichinosis. […] In very rare cases, your provider may recommend a biopsy of some of your tissues to confirm the diagnosis.

• #2 Clinical Overview of Trichinellosis | Trichinellosis (Trichinosis) | CDC

  https://www.cdc.gov/trichinellosis/hcp/clinical-overview/index.html

  Trichinella infections are most often diagnosed via detection of antibodies; muscle biopsy is less frequent. […] The diagnosis of trichinellosis is based on history of consumption of potentially contaminated meat, the presence of compatible signs and symptoms, and identification of Trichinella larvae in biopsy muscle tissue or specific antibody in serum. […] Diagnosis can be challenging, particularly in non-outbreak settings. […] Trichinella infections are most often diagnosed in the laboratory based on detection of antibodies to excretory/secretory Trichinella antigen in EIA format. […] Muscle biopsies are infrequently performed, but they allow for the molecular identification of the Trichinella species or genotype, which is not possible with antibody testing.

• #3 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Trichinellosis-Diagnosis.aspx

  Trichinellosis represents a food-borne zoonotic parasitic disease caused by roundworms from the genus Trichinella. […] It is somewhat difficult to make an early clinical diagnosis of this condition because there are few pathognomonic signs or symptoms. […] Hence, the diagnosis of Trichinella infection should be centered on three principal criteria: clinical findings (identification of characteristic signs and symptoms), laboratory findings (non-specific laboratory parameters, detection of larvae in muscles and/or antibody detection), as well as epidemiological investigation (recognition of the infectious source and origin). […] If patients are suspected to have trichinellosis, the direct identification of parasites necessitates a muscle biopsy. […] The detection of specific anti-Trichinella antibodies in human serum is vital for the diagnosis.

• #4 Epidemiology, Diagnosis, Treatment, and Control of Trichinellosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2620635/

  The diagnosis of trichinellosis should be based on three main criteria: (i) clinical findings (recognition of the signs and symptoms of trichinellosis); (ii) laboratory findings (nonspecific laboratory parameters [eosinophilia and muscle enzymes], antibody detection, and/or detection of larvae in a muscle biopsy); and (iii) epidemiological investigation (identification of source and origin of infection and outbreak studies). […] The diagnosis of trichinellosis should be based on three main criteria: (i) clinical findings (recognition of the signs and symptoms of trichinellosis); (ii) laboratory findings (nonspecific laboratory parameters [eosinophilia and muscle enzymes], antibody detection, and/or detection of larvae in a muscle biopsy); and (iii) epidemiological investigation (identification of source and origin of infection and outbreak studies).

• #5 Trichinosis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/trichinosis/diagnosis-treatment/drc-20378587

  Your health care provider can diagnose trichinosis by discussing your symptoms and doing a physical exam. You provider may also ask if you’ve eaten raw or undercooked meat. […] To diagnose your infection, your health care provider might use these tests: […] Blood tests. Your provider may take a blood sample and test it for signs suggesting trichinosis. These signs include an increase in the number of a type of white blood cell (eosinophils) or the formation of antibodies against the parasite after several weeks. […] Muscle biopsy. A blood test typically is enough to make a diagnosis. But your provider might also recommend a muscle biopsy. A small piece of muscle is removed and examined under a microscope to look for roundworm (trichinella) larvae. […] Trichinella larvae travel from the small intestine through your bloodstream to bury themselves inside muscle tissue. Because of this, stool sample tests don’t often show the parasite.

• #6 Trichinosis Fact Sheet – MN Dept. of Health

  https://www.health.state.mn.us/diseases/trichinosis/trichinosis.html

  How is trichinosis diagnosed? Trichinosis may be suspected based on symptoms and a history of eating raw or undercooked wild game meat or pork. The diagnosis can be confirmed through laboratory testing of blood (for antibodies to Trichinella) or muscle biopsy tissue (for Trichinella larvae). […] Trichinosis can be treated with safe and effective anti-parasitic drugs that are available by prescription. Treatment decisions should be made as early as possible, in consultation with medical experts.

• #7 Trichinellosis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-us/1140

  Trichinellosis is a parasitosis caused by ingestion of under-cooked meat containing Trichinella species larvae. […] The intestinal phase occurs within a few days of ingestion of the parasite and manifests with gastrointestinal symptoms, such as abdominal pain, nausea, vomiting, and diarrhoea. […] The systemic phase most commonly manifests with fever, eosinophilic myositis, myalgia, and peri-orbital oedema, although it may also cause myocarditis and encephalitis. […] Key diagnostic factors include consumption of raw or under-cooked meat, sick contacts, myalgia and myositis, fever, peri-orbital/facial oedema, conjunctivitis and sub-conjunctival haemorrhages. […] Other diagnostic factors include gastrointestinal signs and symptoms, hepatomegaly, oliguria, maculopapular rash, and other neurological features.

• #8 Trichinosis (Trichinellosis) Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/230490-workup

  The clinical identification of trichinellosis presents challenges due to the absence of definitive clinical manifestations, making epidemiologic data crucial for diagnosis. […] Confirmation of the diagnosis is achieved through parasitological analysis of muscle biopsy specimens and detection of specific circulating antibodies. […] Early diagnosis of trichinosis relies on clinician awareness and thorough exploration of the patient’s history, as the initial clinical presentation can be nonspecific. […] A complete blood count (CBC) should be obtained for patients suspected of trichinosis. […] Eosinophilia typically develops around 10 days after infection, with total eosinophil counts rising to as high as 8,700/L (40-80% of total WBC). […] Creatine kinase levels are elevated to 17,000 U/L.

• #9

  https://www.healio.com/news/infectious-disease/20200713/trichinellosis-a-rare-parasitic-infection

  Trichinellosis is a parasitic infection occurring in people who eat meat-eating mammals. […] The diagnosis in an individual is often suspected because of the epidemiological circumstances of multiple cases and the food ingested (eg, bear meat). The clinical findings of fever, muscle pain, periorbital edema and high eosinophilia is suggestive of the disease. In fact, trichinellosis is one of the relatively few diseases that can cause extraordinarily high eosinophil counts. Serological tests for antibodies against Trichinella will confirm the diagnosis, as will a biopsy of striated muscle demonstrating larvae. The serological tests do not turn positive until several weeks into the course of the disease. Muscle biopsy can be helpful in diagnosis in questionable cases but is not usually necessary. […] Elevated levels of muscle enzymes (eg, creatinine phosphokinase, lactate dehydrogenase and aldolase) in blood, which indicate myositis, are found in 75% to 90% of infected persons between the second and fifth weeks of infection and may persist for up to 4 months.

• #10 Trichinellosis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-us/1140

  1st investigations to order include FBC with differential, creatine kinase and other muscle enzymes, serum potassium, serum albumin, and serum IgE. […] Investigations to consider include antibody serology, muscle biopsy, electromyography, urinalysis, serum creatinine and creatinine clearance, serum transaminases, MRI or CT brain, EEG, cerebrospinal fluid analysis, ECG, serum troponin, and Two-dimensional echocardiography.

• #11 Trichinellosis – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/1140?locale=fa

  1st tests to order include CBC with differential, creatine kinase and other muscle enzymes, serum potassium, serum albumin, and serum IgE. […] Tests to consider include antibody serology, muscle biopsy, electromyography, urinalysis, serum creatinine and creatinine clearance, serum aminotransferases, MRI or CT brain, EEG, cerebrospinal fluid analysis, ECG, serum troponin, and Two-dimensional echocardiography.

• #12 Trichinosis – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/nematodes-roundworms/trichinosis

  Diagnosis is clinical with later confirmation by serologic tests. […] No specific tests to diagnose the intestinal stage of Trichinella are available. After the second week of infection, a muscle biopsy may detect larvae and cysts but is seldom necessary. […] A number of serologic tests have been used, but enzyme immunoassay (EIA) using T. spiralis excretory-secretory (ES) antigen seems to be the quickest way to detect the infection and is used in the United States. […] Infection is most commonly diagnosed using enzyme immunoassay.

• #13 CDC – DPDx – Trichinellosis

  https://www.cdc.gov/dpdx/trichinellosis/index.html

  Trichinellosis is caused by the ingestion of undercooked meat containing encysted larvae of Trichinella species. Diagnosis is usually made based on clinical symptoms, and is confirmed by serology or identification of encysted or non-encysted larvae in biopsy or autopsy specimens. […] The suspicion of trichinellosis (trichinosis), based on history, clinical symptoms, and eosinophilia, can be confirmed by specific diagnostic tests, including antibody detection, muscle biopsy, and microscopy. […] Immunodiagnostic tests currently available in the U.S. include enzyme immunoassays (EIA) that detect Trichinella-specific antibodies. […] Positive reactions are detectable at some time during infection in serum samples of 80% to 100% of patients with clinically symptomatic trichinellosis (trichinosis).

• #14 Trichinosis | Health Services Laboratories

  https://www.hslpathology.com/services/hsl-parasitology/tests-for-parasitic-diseases-and-specimen-requirements/trichinosis/

  Trichinosis (also know as Trichinellosis) is caused by the ingestion of encysted larvae of Trichinella spp. within undercooked meat. Larvae are released, mature and mate in the small intestine to produce more larvae which migrate and encyst, most commonly in striated muscle. […] Diagnosis of Trichinosis by microscopy […] Sample type: muscle biopsy. […] Crush/digested preparations of muscle biopsy specimens may reveal larvae. […] Biopsies should also be fixed and sent for histology. […] Diagnosis of Trichinosis by serology […] Sample type: A minimum of 0.5ml of serum is required. […] Serology is the mainstay for diagnosing this condition. […] Except in the rare event of an outbreak in the UK, serology is usually requested for symptoms suggestive of the stage of muscle encystment: myalgia, eosinophilia, and, in the early stages, fever. The IFAT (screening titre 1/32) has proved reliable and specific with positive titres of about 1/128.

• #15 What is Trichinosis? — New Life Diagnostics

  https://www.newlifediagnostics.com/faqs/trichinosis

  Trichinosis infection occurs when a person or animal ingests Trichinella larvae. […] Initial diagnosis of trichinosis relies on the classic symptoms, specifically conjunctivitis, swollen eyelids, and fever. If a patient presents with any of these symptoms after ingesting potentially infected meat, a doctor will then take a blood sample and run one of several simple tests to detect either an increase in certain white blood cells (eosinophils) or the presence of anti-Trichinella antibodies. […] Blood samples are tested for trichinosis using several methods. The first is laboratory testing that looks for the elevated presence of certain white blood cells (eosinophils) and enzymes (creatine kinase, and lactate dehydrogenase). The second method looks for antibodies developed in response to Trichinella infection; these tests include indirect immunofluorescence tests, latex agglutination tests, enzyme-linked immunosorbent assays (ELISA) like the New Life Trichinella Microwell Serum ELISA. Each of these types of test has its own pros and cons, and doctors will often combine testing methods to ensure a definitive diagnosis.

• #16 Trichinosis – Infections – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/infections/parasitic-infections-roundworms-nematodes/trichinosis

  Repeat blood tests are done to detect antibodies to Trichinella spiralis. […] Doctors do blood tests to detect antibodies to Trichinella spiralis. These antibodies are often not detectable until 3 to 5 weeks after symptoms start, so doctors repeat the antibody test at weekly intervals for several weeks to confirm the diagnosis. If antibodies are not detected, doctors usually base an initial diagnosis on the person’s symptoms and on the presence of elevated levels of eosinophils (a type of white blood cell) in a blood sample. […] Doctors may do a biopsy of muscle tissue (in which a sample of tissue is removed and examined under a microscope), but this procedure is usually not necessary.

• #17 CDC – DPDx – Trichinellosis

  https://www.cdc.gov/dpdx/trichinellosis/index.html

  Antibody levels are often not detectable until 3 to 5 weeks post-infection, well after the onset of acute-stage illness. […] Multiple serum specimens should be drawn several weeks apart to demonstrate seroconversion in patients whose initial specimen was negative. […] Antibody levels peak in the second or third month post-infection and then decline slowly for several years. […] In our experience at CDC, EIAs with ES antigens detect antibodies earlier than bentonite flocculation (BF) in 25% of serum specimens from patients with acute infection, but EIAs also remain positive for longer periods after infection than the BF, and are reactive in a larger proportion of persons with no clinical evidence of trichinellosis.

• #18 Trichinella – Serology | Public Health Ontario

  https://www.publichealthontario.ca/en/Laboratory-Services/Test-Information-Index/Trichinella-Serology

  The NRCP reports a sensitivity of 85% and specificity of 93% for their Trichinella serology assay. Serology may be negative in the first two weeks of illness. Serology may remain positive years after resolution of clinical symptoms and may not be able to distinguish active, resolved, or recurrent infection. […] An acute (collected early after the onset of symptoms) and a convalescent (collected 4-12 weeks later) may be required for laboratory diagnosis. […] Trichinella serology testing is referred out to the NRCP. Testing is performed once per week at the NRCP. […] Trichinella serology is performed at the NRCP using a commercial indirect enzyme immunoassay (ELISA) kit for the detection of antibodies to Trichinella larvae. […] In clinical cases where there is strong clinical suspicion for trichinellosis and the results are equivocal or low positive, convalescent serum samples demonstrating a significant rise in antibody level over time may be useful to confirm active infection.

• #19 Trichinellosis | LDBIO Diagnostics

  https://ldbiodiagnostics.com/en/clinic-applications/parasitosis/trichinosis/

  The Haute Autorit de Sant (HAS) in France as well as the American Center for Disease Control (CDC) recommend the immunoblot for the confirmation of serodiagnoses (Argumentaire HAS, 2018, DPDx, Trichinellosis, 2017). […] Several studies reported the efficacy of the immunoblot for a precocious diagnosis, allowing a rapid support of patients and limiting the complications linked to the infection (Yera et al., 2003, Gamble et al., 2004, De Bruyne et al., 2006).

• #20 Trichinosis (Trichinellosis) Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/230490-workup

  Serology results typically do not become positive until 2 to 3 weeks after infection, peaking around the third month and potentially persisting for years. […] Muscle biopsy provides a definitive diagnosis; however, it is rarely recommended except in difficult cases when serology tests are unhelpful. […] The presence of larvae in muscle tissue is pathognomonic. […] A histologic examination may reveal destruction of skeletal muscles, including a basophilic degeneration of the fibers observed on HE-stained sections. […] Case definitions for human trichinosis include possible cases (not applicable), probable cases (patients who meet the clinical criteria and with an epidemiological link), and confirmed cases (patients who meet the laboratory criteria and clinical criteria within the past 2 months).

• #21 Trichinellosis – Helminthiases – Parasitic Diseases – Infectious Diseases – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.18.69.3.

  Trichinellosis should be suspected if the epidemiologic history suggests multiple cases of morbidity related to consumption of uninspected meat and meat products. The amount of consumed meat and the time between consumption and onset of signs and symptoms are relevant for prognosis. […] Serology is the key method of confirming the diagnosis. […] Muscle biopsy: Parasitology: Larvae identified on microscopic examination (this is the definitive confirmation of infection for epidemiologic and legal purposes). […] Eosinophilia (up to 70%) and leukocytosis are early signs observed prior to the onset of clinical manifestations; they may persist for up to 3 months. […] These tests are very useful when combined with eosinophilia, clinical manifestations, and epidemiologic history, allowing for early implementation of treatment.

• #22 Trichinosis – Leeds, Grenville and Lanark District Health Unit

  https://healthunit.org/for-professionals/health-care-dental/communicable-disease-resources/reportable-disease-toolkit/trichinosis/

  Diagnosis is based on clinical presentation and epidemiological evidence and can be confirmed by blood tests and skeletal muscle biopsy. […] Skeletal muscle biopsy taken more than 10 days after infection (most often positive after the fourth or fifth week of infection) frequently provides conclusive evidence of infection. […] Serum antibody titres rarely become positive before the second week of illness; testing paired acute and convalescent serum specimens usually is diagnostic.

• #23 Trichinosis | MedLink Neurology

  https://www.medlink.com/articles/trichinosis

  Trichinosis is an infectious disease caused by consumption of raw meat contaminated with larvae of nematode in the genus Trichinella. […] A definitive diagnosis is established by demonstration of larvae in muscle, blood, or cerebrospinal fluid. […] Trichinosis should be considered in patients with fever, myalgia, periorbital edema, eosinophilia, and a history of recent consumption of poorly cooked meat, especially pork or wild game. […] The definitive diagnosis is by demonstration of larvae in the muscle, blood, or cerebrospinal fluid.

• #24 Trichinosis (Trichinellosis) Differential Diagnoses

  https://emedicine.medscape.com/article/230490-differential

  Early diagnosis of trichinosis is particularly difficult owing to a lack of easily detectable pathognomic signs and symptoms. […] Given the nonspecific laboratory parameter of eosinophilia, other parasitic infections to consider those listed below. […] Diagnostic Considerations.

• #25 Trichinosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK536945/

  Serology confirms suspected trichinosis infection when anti-Trichinella IgG antibodies are detected. […] Once a diagnosis of trichinosis is confirmed, therapy implementation should begin as soon as possible. […] The primary drug treatment for trichinosis is antihelminthics. […] Trichinosis presents with eosinophilia and intestinal symptoms in early infection. […] Early diagnosis and treatment will reduce disease severity, but delay reduces the efficacy of antihelminthic drugs as larvae enter striated muscle. […] Trichinosis is a difficult diagnosis, especially in areas where the infection is not endemic, and there has been no outbreak.

• #26 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Trichinellosis-Treatment-and-Prevention.aspx

  With early diagnosis, Trichnellosis can be treated with prescription drugs. […] Effective and safe prescription drugs are available for the treatment of both trichinellosis and the symptoms that arise as a consequence of infection. However, the treatment must be administered to the patient before acute stage of the disease runs its course, as drugs are impotent once the larvae are established in the muscle. For this reason, early diagnosis is of the utmost importance. […] The effectiveness of these drugs depends greatly on the time of administration. Evidence shows that favorable results can be achieved only if the drugs are administered in the early stage of infection. Unfortunately, most affected individuals are diagnosed several weeks after the infection has set in, which means the larvae of Trichinella have already established themselves in the muscle tissue.

• #27 Trichinosis – Wikipedia

  https://en.wikipedia.org/wiki/Trichinosis

  Diagnosis of trichinosis is confirmed by a combination of exposure history, clinical diagnosis, and laboratory testing. […] An epidemiological investigation can be done to determine a patient’s exposure to raw infected meat. […] Clinical presentation of the common trichinosis symptoms may also suggest infection. […] Blood tests and microscopy can be used to aid in the diagnosis of trichinosis. […] In some cases, muscle biopsies are performed, where „0.2 to 0.5 grams of human or animal skeletal muscle tissue is collected and examined for Trichinella larvae via artificial digestion or histological analysis.”

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