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There is no consensus on the benefits of treatment with any specific anthelminthic compound on muscle-stage trichinosis. A
double-blind, placebo-controlled comparison was done of 3 antiparasitic drugs during an outbreak of trichinosis in Chiangrai
Province, northern Thailand. Forty-six adults were randomized to receive 10 days of oral treatment wit...
Contexts in source publication
Context 1
... patients were ambulatory at the time of study entry, but half the placebo-treated volunteers became unable to walk because of increasing muscle pain and weakness. Significantly fewer patients in the thiabendazole and mebendazole groups became unable to walk (table 2). No thiabendazole-treated sub- jects had lower serum albumin concentrations on day 7 than JID 2000;182 (July) on day 0 ( vs. placebo). ...
Context 2
... baseline values, there were significant reductions in muscle en- zyme concentrations on days 3 and 7 and significant increases in day 7 albumin levels in the thiabendazole group only (table 2). Hypoalbuminemia is a marker of severe trichinosis and is thought to be related to protein use by larvae growing in muscle [11]. ...
Citations
... Antiparasitic Mebendazole ® (200 to400mg 3 times a day orally for 3 days, and then 400 to 500mg three times a day orally for 10 days or Albendazole ® (400mg twice a day orally for 8 to 14 days) are appropriate in setting of symptomatic infection, mainly in complicated infections of CNS, myocardium, or respiratory muscles (CDC, 2020). Drugs were useful to treat larvae actively invading gastrointestinal tract, but their benefit in setting of bloodborne or muscle-encysted larvae was uncertain (Watt et al, 2000). Mebendazole treated patients with less myositis and muscle pain than those received placebo, but with viable encysted muscle larvae . ...
Trichinella spiralis is the smallest viviparous nematode parasite, occurring in rodents, pigs, bears, hyenas and humans, causing trichinosis. It is sometimes referred to as the pork worm due to typical encountered in undercooked pork products. It should not be confused with the distantly related pork tapeworm. Trichinosis (trichinellosis) causes headaches, fevers, myalgias, chills, cough, swelling of the face and eyes, aching joints and muscle pains, itchy skin, diarrhea, or constipation may follow the first symptoms. But, early clinical diagnosis is so difficult without specific trichinellosis signs or symptoms. Man becomes infected when eat raw or undercooked meats, particularly bear, pork, wild feline (such as a cougar), fox, dog, cat, wolf, horse, seal, or walrus may carry the parasite. Host animals' ingested even high numbers of Trichinella larvae from infectious meat don't develop clinical symptoms such as those occurred in human patients. Person-to-person spread does not occur. Mild to moderate infections most symptoms fatigue, weakness, muscle pain, and diarrhea may last for months subside within a few months. In heavy infection (myocarditis & encepha-litis) patients may experience difficulty coordinating movements, with heart and breathing problems can be fatal. Mebendazole ® and/or Albendazole ® killed adults, and thus preventing more release of infected larvae and stopping infection within the patient.
... Antiparasitic Mebendazole ® (200 to400mg 3 times a day orally for 3 days, and then 400 to 500mg three times a day orally for 10 days or Albendazole ® (400mg twice a day orally for 8 to 14 days) are appropriate in setting of symptomatic infection, mainly in complicated infections of CNS, myocardium, or respiratory muscles (CDC, 2020). Drugs were useful to treat larvae actively invading gastrointestinal tract, but their benefit in setting of bloodborne or muscle-encysted larvae was uncertain (Watt et al, 2000). Mebendazole treated patients with less myositis and muscle pain than those received placebo, but with viable encysted muscle larvae . ...
... Trichinellosis is supposed to be present in domestic pigs from Myanmar because an outbreak occurred in Northern Thailand after people had consumed pork illegally imported from Myanmar (Watt et al., 2000). However, no other studies have been performed. ...
To present the situation of human trichinellosis in Southeast Asia in the last 20th years we analyzed outbreak data and seroprevalence studies from 2001 to 2021 for this region. We queried PubMed (https://pubmed.ncbi.nlm.nih.gov) using keywords “Trichinella”, “human” and “Southeast Asia”. In addition, we described Trichinella species circulating in this region.
In Southeast Asia, in communities eating pork, several cultural factors play important roles in the transmission of Trichinella to humans. The seroprevalences of Trichinella infection in humans are known for Laos and Vietnam to be 0–10.5% in some villages. Also, in Cambodia, Laos, Malaysia, Thailand and Vietnam relatively few human outbreaks (13) and cases (1604) have been recorded during the last 21st years. Their associated mortality rates were low (0.75%). Trichinella spiralis and T. papuae were transmitted after consumption of raw or undercooked pork from domesticated and wild pigs. T. papuae transmission was related to consumption of wild boar. In this region, trichinellosis was frequently subclinical and clinical or severe cases were sporadic and occurred more in male patients. Nevertheless, it is likely that trichinellosis is widely under-diagnosed and is an endemic disease.
... Treatment: Trichinella treatment was with systemic symptoms (including central nervous system manifestations, cardiac inflammation or pulmonary involvement) consists of antiparasitic therapy with corticosteroids (Watt et al, 2000). Anti-parasites; Albendazole ® as 400mg orally twice daily for 10 to 14 days), or Mebendazole ® as 200 to 400mg three times daily for 3 days, then 400 to 500 mg three times daily for 10 days (Murrell and Bruschi, 1994). ...
... e recommended first-line medications, albendazole 400 mg bid for 14 days and prednisolone 30 mg po bid for 14 days, were given for our case [34]. Antiparasitic therapy is effective in treating larvae that burrow into the gastrointestinal tract [38]. However, the benefits of antiparasitic therapy in the case of blood-borne larval invasion or encysting of the muscle are unknown; treatment after muscle invasion may fail to eliminate infective larvae from the muscle. ...
... In severe cases, prednisone at a dose of 30 to 60 mg/day for 10 to 15 days may be administered concurrently [36,38,39]. ...
Background. Trichinellosis develops after ingestion of Trichinella cysts in pork meat. It is one of the most important parasitic
human pathogens in the world. It is, however, underreported in part because none of the clinical manifestations are pathognomonic. %e primary mode of transmission is ingestion of raw meat. Among the symptoms are muscle pain, swelling, and
myopathy. High-grade fever and other systemic symptoms are not unusual. %e hallmarks are ophthalmic and musculoskeletal
manifestations, particularly conjunctival haemorrhage with periorbital edema and subungual splinter haemorrhage. Although the
majority of infections are mild and asymptomatic, severe infections can result in enteritis, periorbital edema, and myositis.
Presentation of the Case. A 14-year-old male patient from Oromia Region, Arsi Zone, West Arsi Zone, Bishan Guracha area, which
is almost completely encircled by mountains, presented with a complaint of worsening easy fatigability and asymmetric right thigh
enlargement lasting one month. %e pertinent physical examinations on presentation were puffy face and eyes, and there was a
4 cm by 5 cm mass on the right lateral thigh with no overlying skin colour change, on-tender, and no discharge. Eosinophilia of
14% was noticed on the complete blood count. %e definitive diagnosis of trichinellosis was made by muscle biopsy. He was then
managed with albendazole and prednisolone and improved. Conclusion. Patients with periorbital edema, myositis, or eosinophilia
should be evaluated for trichinellosis. Individuals who have these symptoms and a history of eating pork meat should be suspected
of having trichinellosis. Before eating raw pork meat, it is recommended that it be cooked properly.
... e recommended first-line medications, albendazole 400 mg bid for 14 days and prednisolone 30 mg po bid for 14 days, were given for our case [34]. Antiparasitic therapy is effective in treating larvae that burrow into the gastrointestinal tract [38]. However, the benefits of antiparasitic therapy in the case of blood-borne larval invasion or encysting of the muscle are unknown; treatment after muscle invasion may fail to eliminate infective larvae from the muscle. ...
... In severe cases, prednisone at a dose of 30 to 60 mg/day for 10 to 15 days may be administered concurrently [36,38,39]. ...
Background:
Trichinellosis develops after ingestion of Trichinella cysts in pork meat. It is one of the most important parasitic human pathogens in the world. It is, however, underreported in part because none of the clinical manifestations are pathognomonic. The primary mode of transmission is ingestion of raw meat. Among the symptoms are muscle pain, swelling, and myopathy. High-grade fever and other systemic symptoms are not unusual. The hallmarks are ophthalmic and musculoskeletal manifestations, particularly conjunctival haemorrhage with periorbital edema and subungual splinter haemorrhage. Although the majority of infections are mild and asymptomatic, severe infections can result in enteritis, periorbital edema, and myositis. Presentation of the Case. A 14-year-old male patient from Oromia Region, Arsi Zone, West Arsi Zone, Bishan Guracha area, which is almost completely encircled by mountains, presented with a complaint of worsening easy fatigability and asymmetric right thigh enlargement lasting one month. The pertinent physical examinations on presentation were puffy face and eyes, and there was a 4 cm by 5 cm mass on the right lateral thigh with no overlying skin colour change, on-tender, and no discharge. Eosinophilia of 14% was noticed on the complete blood count. The definitive diagnosis of trichinellosis was made by muscle biopsy. He was then managed with albendazole and prednisolone and improved.
Conclusion:
Patients with periorbital edema, myositis, or eosinophilia should be evaluated for trichinellosis. Individuals who have these symptoms and a history of eating pork meat should be suspected of having trichinellosis. Before eating raw pork meat, it is recommended that it be cooked properly.
... Treatment involves albendazole or mebendazole, severe myositis should include the addition of corticosteroids. 3,72,73 Cysticercosis ...
Infectious myositis (IM), is the infection of the skeletal muscle tissue (particularly voluntary muscle), which is characterized by swelling, pain, tenderness and/or weakness and is most commonly caused by bacteria, frequently by Staphylococcal and Streptococcal species. Acute bacterial myositis is the diffuse infection of the muscle without an intramuscular abscess. Group A Streptococcus (GAS), is the most common cause of cellulitis and various muscular infections like pyomyositis, subacute myositis, acute myositis and malignant myositis. Viral agents are the most common cause of nonbacterial infectious myositis. Among viruses, influenza is the most frequent causative agent reported to cause viral myositis. Fungal infections of the musculature are relatively uncommon; most of the cases are seen in immunocompromised patients and the diagnosis is established through biopsy with the culture of the specimens. History of food ingestion along with eosinophilia points towards a parasitic causative agent.
... Triazoles including fluconazole are long lasting with low bio-degradability in natural conditions ( Wang et al., 2011;Bergheim et al., 2014). Fluconazole is a bis-triazole antifungal compound (Saag & Dismukes, 1988), which remains almost unchanged when excreted by human beings or animals ( Hess et al., 1986;Watt et al., 2000) and become persistent in soil and water (Bromillow et al., 1999). They are taken up by non-target animals through contaminated food and water and thereafter affect their homeo- stasis. ...
An experiment was carried out to delineate the biochemical responses in Labeo rohita fingerlings fed with fluconazole (FLZ). There were twenty-four treatments divided into four groups (Control, T1, T2, and T3 fed with 0, 10, 20 and 30 mg FLZ kg-1 body weight, respectively) and each group with 6 exposure times (0, 6, 12, 24, 48, and 96 h) in triplicates. Biochemical parameters in plasma like glutamate oxaloacetate transaminase (GOT), glutamate pyruvate transaminase (GPT), alkaline phosphatase (ALP), glucose, albumin, albumin globulin ratio (A/G) were measured. Significant increase (p<0.05) in the GOT, ALP, and decrease (p<0.05) in glucose were observed in the treatment groups as compared to control. However, homeosta-sis was achieved by rohu within 48 h of administration. Fish fingerlings treated with fluconazole at higher doses exhibited marked changes in physiology .
... Death generally is ascribed to myocarditis, meningeoencephalitis or pneumonitis (Pozio et al. 2003). Respiratory failure due to specific muscle involvement, especially diaphragm may lead to fatal consequences (Compton et al. 1993, Watt et al. 2000. ...
Trichinellosis is a meat-borne helminthic zoonosis, caused by different species of the genus Trichinella. The disease is cosmopolitan in distribution and affects around 10,000 people annually around the globe. Based on genetic, biochemical and biological variability, 9 valid species (T. britovi, T. murrelli, T. nativa, T. nelsoni, T. papuae, T. patagoniensis, T. pseudospiralis, T. spiralis and T. zimbabwensis) and 3 genotypes (Trichinella T6, T8 and T9) of the parasite have been recognized. These species infect around 100 mammalian species including domestic and wild pigs, horses, game animals and wild carnivores. The infection starts with consumption of raw or undercooked meat or meat products containing encysted muscle larvae of the parasite. Most of the infections or outbreaks have been associated with the consumption of meat or meat products of pigs, wild boars, horses, crocodiles, walruses and dogs. Trichinoscopy is used in the veterinary inspection of pork in slaughterhouses and meat-packing facilities in many countries. It is a rapid process, but low in sensitivity and fails to detect mild infection. The muscle digestion method using HCl-pepsin is more sensitive and thus preferred. Recent outbreak of trichinellosis in Uttarakhand state opened up issues related to rapid diagnosis and lack of consumer awareness regarding safe cooking habits of meat of pig origin. This status report is an attempt to compile the information on Trichinella spp. infection in animals and humans in India at one place to draw the attention of medical and veterinary personnels involved in disease investigation and active research on zoonotic diseases. © 2018 Indian Council of Agricultural Research. All rights reserved.
... In severe cases, patient may suffer from meningitis, encephalitis, myocarditis, and even death [44]. Albendazole or mebendazole with corticosteroids are commonly used for treatment of the parasite infection [45]. However, they have low bioavailability due to poor water solubility that limits their absorption [46]. ...
