Last reviewed: November 2017
Last updated: July  2017

Summary

Definition

History and exam

Key diagnostic factors

  • consumption of raw or under-cooked meat
  • sick contacts
  • myalgia and myositis
  • fever
  • peri-orbital/facial oedema
  • conjunctivitis and sub-conjunctival haemorrhages

Other diagnostic factors

  • subungual and retinal splinter haemorrhages
  • other ocular features
  • nausea and vomiting
  • abdominal pain
  • diarrhoea
  • hepatomegaly
  • oliguria
  • maculopapular rash
  • other cutaneous features
  • dysphagia
  • dysphonia
  • dyspnoea
  • headache
  • paralysis-like state
  • other neurological features

Risk factors

  • consumption of raw or under-cooked pork
  • consumption of raw or under-cooked horse or other domestic animal meat
  • consumption of raw or under-cooked wild game meat
  • consumption of raw or under-cooked reptile meat

Diagnostic investigations

1st investigations to order

  • FBC with differential
  • creatine kinase and other muscle enzymes
  • serum potassium
  • serum albumin
  • serum IgE
Full details

Investigations to consider

  • antibody serology
  • muscle biopsy
  • electromyography
  • urinalysis
  • serum creatinine and creatinine clearance
  • serum transaminases
  • MRI or CT brain
  • EEG
  • CSF analysis
  • ECG
  • serum troponin
  • 2-dimensional echocardiography
Full details

Emerging tests

  • circulating antigens
  • DNA amplification
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Miguel G. Madariaga

Infectious Diseases Consultant

Naples Community Hospital

Naples

FL

Disclosures

MGM declares that he has no competing interests.

Peer reviewers VIEW ALL

Professor of Parasitology

Department of Experimental Pathology BMIE

Faculty of Medicine and Surgery

University of Pisa

Pisa

Italy

Disclosures

FB is an author of a number of references cited in this monograph.

Chef du Service de Parasitologie-Mycologie

Hôpital Cochin

Paris

France

Disclosures

JDC is an author of a number of references cited in this monograph. JDC declares that he has no competing interests.

Associate Professor

Division of Infectious Diseases

Department of Medicine

University of Vermont College of Medicine

Burlington

VT

Disclosures

CDH declares that he has no competing interests.

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