Trichinellosis

What it is

From: Orphanet

Trichinellosis is a zoonotic parasitic disease caused by the consumption of raw or undercooked meat (pork and wild game) infected by nematodes of the genus Trichinella and that is characterized by an enteral (intestinal) phase, that can be asymptomatic or that can manifests with diarrhea, nausea, vomiting and abdominal pain, and a parenteral (muscular) phase, manifesting with fever, periorbital edema, muscle swelling and pain, weakness, and in some cases, skin rash and peripheral edema. Rarely, potentially fatal cardiac (i.e. myocarditis), pulmonary (i.e. pneumonitis, respiratory failure), and nervous system (i.e. meningoencephalitis) complications may occur.

Reported clinical features and what the terms mean

The following findings are associated with this condition in Orphanet. They are not a checklist for diagnosing yourself, and they do not all occur in every affected person. Some are examination, imaging or laboratory findings that cannot be recognised at home.

The frequency labels describe how often a finding was reported among people with the condition in the source. They do not give the chance that a person with that symptom has the condition. Definitions below reproduce HPO terminology; they explain the term, not the likely severity in an individual.

Conjunctival hyperemia · Frequent (79-30%)

Dilatation of the blood vessels of the conjunctiva leading to a red appearance of the sclera.

EMG abnormality · Frequent (79-30%)

Abnormal results of investigations using electromyography (EMG).

Edema · Frequent (79-30%)

An abnormal accumulation of fluid beneath the skin, or in one or more cavities of the body.

Hyporeflexia · Frequent (79-30%)

Reduction of neurologic reflexes such as the knee-jerk reaction.

Increased circulating IgE concentration · Frequent (79-30%)

An abnormally increased overall level of immunoglobulin E in blood.

Muscle weakness · Frequent (79-30%)

Reduced strength of muscles.

Nausea · Frequent (79-30%)

A sensation of unease in the stomach together with an urge to vomit.

Periorbital edema · Frequent (79-30%)

Edema affecting the region situated around the orbit of the eye.

Facial edema · Frequent (79-30%)

Abnormality of eye movement · Occasional (29-5%)

An abnormality in voluntary or involuntary eye movements or their control.

Abnormality of the cardiovascular system · Occasional (29-5%)

Any abnormality of the cardiovascular system.

Abnormality of the cerebrospinal fluid · Occasional (29-5%)

An abnormality of the cerebrospinal fluid (CSF).

Apathy · Occasional (29-5%)

Apathy is a quantitative reduction of interest, motivation and the initiation and persistence of goal-directed behavior, where often the accompanying emotions, thoughts, and social interactions are also diminished. The individual is typically non-reactive to provocations, positive or negative, and appears to not care. Distinguished from lethargy which involves lack of physical or mental energy.

Atypical behavior · Occasional (29-5%)

Atypical behavior is an abnormality in a person's actions that can be controlled or modulated by the will of the individual. While abnormal behaviors can be difficult to control, they are distinct from other abnormal actions that cannot be affected by the individual's will.

Other findings in the same source

From: Orphanet

Additional reported features include Confusion (Occasional (29-5%)); Conjunctivitis (Occasional (29-5%)); Dysphagia (Occasional (29-5%)); Excessive daytime somnolence (Occasional (29-5%)); Hemiparesis (Occasional (29-5%)); Irritability (Occasional (29-5%)); Lethargy (Occasional (29-5%)); Memory impairment (Occasional (29-5%)); Ocular pain (Occasional (29-5%)); Ophthalmoplegia (Occasional (29-5%)). This is a selected summary, not a complete description of the condition.

When it may begin

From: Orphanet

All ages

Inheritance in the source

From: Orphanet

Not applicable

Frequency and the population described

From: Orphanet

Annual incidence: <1 / 1 000 000; Europe; Value and class. Annual incidence: 1-9 / 1 000 000; Bulgaria; Value and class. Annual incidence: <1 / 1 000 000; Croatia; Value and class. Annual incidence: <1 / 1 000 000; Estonia; Value and class.

Which doctor should you see?

The suggested department for discussing Trichinellosis is Infectious Diseases, with a general physician / infectious disease specialist as the relevant type of clinician. General physician / Family Medicine; paediatrician for children. Referral depends on symptoms.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• Which exposure or organism is suspected, and what evidence would confirm it?
• Are precautions, vaccination or advice for close contacts relevant to this infection?
• What should happen if symptoms worsen or do not improve as expected?

Treatment discussions and follow-up

The material gathered for this draft does not provide a complete condition-specific treatment pathway for Trichinellosis. That gap does not mean that treatment is unavailable. A clinician needs to establish the diagnosis and review current guidance before recommending medicines, procedures, rehabilitation or other support.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

The collected references do not establish a complete prevention or long-term outlook section for this entry. Missing information should not be interpreted as proof that prevention is impossible or that a particular outcome is inevitable. Ask what is known for the exact subtype, stage and personal circumstances, and which uncertainties remain.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.