Trichinella infection and clinical disease

Trichinellosis is caused by ingestion of insufficiently cooked meatcontaminated with infective larvae of Trichinellaspecies. The clinical course is highly variable, ranging from no apparentinfection to severe and even fatal disease. We report two illustrativecases of trichinellosis. Returning to Denmark a few days after having eatenroasted pork in the Republic of Serbia, a female patient suffered fromsevere vomiting, epigastric pain, diarrhoea, and later myalgia, generalizedoedema, and prostration. A biopsy showed heavy infestation withTrichinella spiralis, 2000 larvae/g of muscle.Life-threatening cardiopulmonary, renal and central nervous systemcomplications developed. The patient recovered after several months. Herhusband, who also ate the pork, did not have clinical symptoms, but anincreased eosinophil count and a single larva in a muscle biopsy confirmedinfection. The epidemiology, clinical manifestations, diagnosis, treatmentand prevention of trichinellosis are reviewed.