Trichinosis is caused by the nematode Trichinella spiralis. For humans, the most important source of infection is eating undercooked pork containing Trichinella cysts, from pigs fed untreated garbage containing infected rodents. Following ingestion, larvae hematogenously disseminate and invade skeletal muscle—the only tissue of encystment.
The most common symptoms and signs of infection are:
An inflammatory response can be evoked, however, which can affect other organ systems, including the central nervous system (CNS). A meningoencephalitis can result. About 5% of patients with trichinosis demonstrate neurologic signs, including seizures.174
The clinical syndrome of fever, periorbital and peripheral edema, and firm and tender muscles in a patient who has eaten pork within the past 2 to 10 days is suggestive of trichinosis. Eosinophils, larvae, or both can be found in cerebrospinal fluid (CSF) in up to 28% of cases.162 Muscle biopsy can confirm the diagnosis.
Treatment is thiabendazole and steroids. Seizure management is routine.
Reviewed and revised March 2004 by Steven C. Schachter, MD, epilepsy.com Editorial Board.
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