Materiały źródłowe

• #1 Trichinella spiralis Infection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538511/

  Trichinellosis usually has a benign course and is self-limiting. Full recovery of patients within 2 months to 6 months of infection is the expectation. […] However, some cases might be severe, and even death is a possibility. Death is rare if the cardiac and CNS remain uninvolved. Some individuals with CNS involvement may have residual deficits long-term. The prognosis of the disease proportionately correlates with the parasitic burden.

• #2 Trichinella spiralis Infection (Trichinosis) – MD Searchlight

  https://mdsearchlight.com/infectious-disease/trichinella-spiralis-infection-trichinosis/

  The prognosis for Trichinella spiralis infection (Trichinosis) is generally good, as most cases have a mild course and can heal by themselves. Patients are usually expected to fully recover within 2 to 6 months of getting the infection. However, in rare instances, the infection can be severe and lead to death, especially if the central nervous system is affected. The severity of the disease is mainly connected to the number of parasites in the body.

• #3 Trichinosis – UF Health

  https://ufhealth.org/conditions-and-treatments/trichinosis

  Most people with trichinosis have no symptoms and the infection goes away by itself. More severe infections may be difficult to treat, especially if the lungs, heart, or brain are involved.

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

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

  Most people enjoy a full recovery from trichinosis even though it may take weeks or even months to feel better completely. […] The outlook for severe cases of trichinosis that result in brain or heart damage is less positive.

• #5 Trichinosis | MedLink Neurology

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

  The severity and prognosis of trichinosis in humans depends on the parasitic burden. In most cases, the symptoms are considered mild or even asymptomatic. On the other hand, the prognosis in patients with heavy larvae burden (more than 1000 larvae per gram of muscle) is poor and may be fatal. […] Damage to internal organs can occur during the phase of larvae migration. Such larvae migration-induced tissue injuries are usually fully recoverable. However, damage causing permanent deficit can also occur. These deficits include hemorrhagic maculopathy with focal atrophy of retinal pigment epithelium, permanent cardiac conduction defect, and various forms of permanent focal neurologic deficits. […] In a 30-year retrospective study at a Romanian hospital, 558 patients infected with trichinosis were included. Severe forms of trichinosis were observed as follows: 24.69% had neurologic complications, 3.4% had cardiac complications, and 2.5% had respiratory complications. Antiparasitic medication was administered to 97.85% of patients, and 77% received corticosteroids. The mean hospital stay was 8.46 days. No fatalities were recorded in this study; however, morbidity was not reported.

• #6 Trichinosis – StatPearls – NCBI Bookshelf

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

  There is a poor prognosis for severe cases that include cerebral or cardiac complications. Even with therapy, the mortality rate in those with severe infection is 5%. Milder cases have a good prognosis with symptoms disappearing in 2-6 months.[9] […] Early diagnosis and treatment will reduce disease severity, but delay reduces the efficacy of antihelminthic drugs as larvae enter striated muscle. Trichinella larvae can survive in muscle tissue for many years so long-term follow-up may be necessary.[13]

• #7 Trichinosis – MD Searchlight

  https://mdsearchlight.com/infectious-disease/trichinosis/

  Outcomes can be poor for severe cases of this condition that involve brain or heart complications. Despite treatment, about 5% of those with severe infections do not survive. […] Patients with milder cases have a good outlook. Their symptoms typically go away within 2 to 6 months.

• #8 Central Nervous System Involvement in Trichinellosis: A Systematic Review

  https://www.mdpi.com/2075-4418/11/6/945

  We reviewed the evidence on features of central nervous system (CNS) involvement in trichinellosis, systematically searching five databases (to January 2021). […] They were suggestive of severe infection if they substantially raised death probability. […] The best poor prognosis predictor is mydriasis (positive likelihood ratio 9.08). […] The most severe complications are related to the CNS, heart, and lungs. […] The CNS involvement was reported in 10–20% of patients and is usually associated with severe Trichinella infection. […] However, with the treatment with corticosteroids and benzimidazoles (e.g., mebendazole and albendazole), the number of fatal outcomes has decreased. […] The clinical signs with an LR+ between 5 and 10, indicating an increased chance of death with 30–45%, included mydriasis, paraparesis, dysphagia, psychomotor seizures, and delirium.

• #9 Central Nervous System Involvement in Trichinellosis: A Systematic Review

  https://www.mdpi.com/2075-4418/11/6/945

  The highest LR+ was obtained for mydriasis (9.08), paraparesis (6.05), dysphagia (6.05), psychomotor seizures (6.05), and delirium (5.30). […] Interestingly, clinical findings that usually for a neurologist are red flags, such as bilateral Babinski sign, lethargy, stupor, or positive Kerning sign, present a low LR+. […] The absence of pathological findings in CSF does not exclude a poor prognosis. […] Therefore, it may be postulated that a lack of eosinophilia indicates a poor outcome in patients with a severe symptomatology, but further investigation of this paraclinical parameter is necessary. […] Despite the limitations mentioned above, our study represents the first systematic review of the literature published in this field and outlines an accurate state of knowledge of cerebral and meningeal implications in acute Trichinellosis.

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