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Can Med Assoc J. 1966 October 29; 95(18): 912–917.
PMCID: PMC1935701

Human Trichinosis

Report of Four Cases, with Emphasis on Central Nervous System Involvement, and a Survey of 500 Consecutive Autopsies at the Ottawa Civic Hospital

Abstract

In 1963, acute trichinosis was recognized in four patients at the Ottawa Civic Hospital. One presented with cavernous sinus thrombosis and sixth nerve palsy. A second had a severe systemic infection with myocarditis; the signs of myocarditis appeared in the third week. Electrocardiographic abnormalities included T-wave flattening, prolongation of PR interval and QRS complex, and non-specific changes in 25%. Central nervous system involvement occurred in the second week with general symptoms (headache, delirium and psychotic behaviour), followed in the third week by focal signs (nerve palsy, convulsion, pareses and coma).

The incidence of trichinosis in the U.S.A. fell from 15.9% before 1948 to 4.5% in the period 1948-1963. The Canadian incidence in the period from 1940 to 1943 was 5.6%. In a survey in Ottawa using the Baermann digestion and compression methods, four positive cases were found out of 500 diaphragms examined. These figures indicate the success of the public health regulations aimed at controlling trichinosis. A gastrocnemius muscle biopsy is still an invaluable diagnostic tool, especially in critically ill patients with negative skin tests and no eosinophilia.

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Selected References

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  • GRAY DF, MORSE BS, PHILLIPS WF. Trichinosis with neurologic and cardiac involvement. Review of the literature and report of three cases. Ann Intern Med. 1962 Aug;57:230–244. [PubMed]
  • JACKSON GJ. Fluorescent antibody studies of Trichinella spiralis infections. J Infect Dis. 1959 Sep-Oct;105:97–117. [PubMed]
  • AIKAWA JK, HARRELL GT, MILLER TB. The immunophysiology of trichinosis; alterations in the blood volume and the thiocyanate space in relation to the development of humoral antibodies in the rabbit. J Clin Invest. 1951 Jun;30(6):575–581. [PMC free article] [PubMed]
  • Sawitz W. Are Post-Mortem Statistics on Trichinosis Valid for the Living Population? Am J Public Health Nations Health. 1937 Oct;27(10):1023–1024. [PubMed]
  • MAYNARD JE, KAGAN IG. INTRADERMAL TEST IN THE DETECTION OF TRICHINOSIS. FURTHER OBSERVATIONS ON TWO OUTBREAKS DUE TO BEAR MEAT IN ALASKA. N Engl J Med. 1964 Jan 2;270:1–6. [PubMed]
  • MOST H. TRICHINELLOSIS IN THE UNITED STATES: CHANGING EPIDEMIOLOGY DURING PAST 25 YEARS. JAMA. 1965 Sep 13;193:871–873. [PubMed]
  • BOURNS TKR. Trichinosis in the Vancouver area; examination of 400 human diaphragms. Can J Public Health. 1953 Apr;44(4):134–136. [PubMed]
  • DALESSIO DJ, WOLFF HG. Trichinella spiralis infection of the central nervous system. Report of a case and review of the literature. Arch Neurol. 1961 Apr;4:407–417. [PubMed]
  • POOLE JB. The incidence of human trichinosis in Canada. Can J Public Health. 1953 Aug;44(8):295–298. [PubMed]

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