[Diagnosis and treatment of trichinellosis]

Lack of specific symptoms and signs makes clinical diagnosis of trichinellosis difficult. Epidemiological information is important, such as a history of ingesting raw or undercooked meat. An outbreak can be traced to a group of people dining together. Usual manifestations include abdominal pain or diarrhea with general discomfort in the enteric stage, and fever, eyelid or facial edema, muscle pain in acute stage. Complications, such as myocarditis, pneumonia, encephalitis, may develop in severe cases. Eosinophilia appears between 2 and 5 weeks after infection. Enzyme-linked immunosorbent assay (ELISA) using the excretory-secretory (ES) antigens of the muscle larvae or synthetic tyvelose as antigen is sensitive and specific, the serological method ,of choice as a screening test. Western blotting is needed to confirm the positive ELISA. Definitive diagnosis depends on the finding of larvae in a muscle biopsy specimen. Albendazole is the drug of choice for its treatment, 20-30 mg/(kg x d), two times daily for 5-7 days. Glucocorticosteroids are given only to severe cases and always be used in combination with albendazole, since they could prolong the intestinal phase of the infection and increase the muscle larval burdens.