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February 10, 2012

Trichinosis (cont.)

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How is trichinosis treated?

Most trichinosis infections, according to the experts, are subclinical or have minor symptoms and do not require any treatment as they are self-limited (all symptoms resolve without treatment). In patients with more intense symptoms, thiabendazole (Mintezol) can be used to eliminate the adult worms in the gastrointestinal tract. Albendazole (Albenza) is another drug that may be used in some cases. The invasive and encysted larva forms of Trichinella species are treated by mebendazole (Vermox). Inflammation of infected tissues is usually treated with prednisone and is frequently used in combination with mebendazole.

Are there complications associated with trichinosis?

About 90%-95% of trichinosis infections have either minor or no symptoms and no complications. Patients with more serious symptoms, however, may develop complications such as heart muscle inflammation (myocarditis), pulmonary problems such as cough, short of breath or lung hemorrhage (lung bleeding). Also, central nervous system (CNS) problems may develop. The CNS symptoms are diverse; they include confusion, delirium, ataxia, seizures, vertigo, auditory and speech changes along with many other neurological deficits. For some patients, these complications can slowly resolve over six months. In other patients, the complications can persist for years.

What is the prognosis for patients with trichinosis?

For those who have minor or no symptoms, the prognosis is excellent with no complications. For the minority of patients that develop complications, the prognosis is still good as most will recover and the symptoms will decrease and disappear. However, for a few patients, the prognosis is less clear as complications, especially those with the brain disease, which may persist for many years. Less than 0.1%-0.3% patients with trichinosis die from the disease.



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