Summary
Definition
History and exam
Key diagnostic factors
- consumption of raw or undercooked meat
- sick contacts
- myalgia and myositis
- fever
- periorbital/facial edema
- conjunctivitis and subconjunctival hemorrhages
Other diagnostic factors
- subungual and retinal splinter hemorrhages
- other ocular features
- gastrointestinal signs and symptoms
- hepatomegaly
- oliguria
- maculopapular rash
- other cutaneous features
- dysphagia
- dysphonia
- dyspnea
- headache
- paralysis-like state
- other neurologic features
Risk factors
- consumption of raw or undercooked pork
- consumption of raw or undercooked horse or other domestic animal meat
- consumption of raw or undercooked wild game meat
- consumption of raw or undercooked reptile meat
Diagnostic tests
1st tests to order
- CBC with differential
- creatine kinase and other muscle enzymes
- serum potassium
- serum albumin
- serum IgE
Tests to consider
- antibody serology
- muscle biopsy
- electromyography
- urinalysis
- serum creatinine and creatinine clearance
- serum aminotransferases
- MRI or CT brain
- EEG
- cerebrospinal fluid analysis
- ECG
- serum troponin
- Two-dimensional echocardiography
Treatment algorithm
nonpregnant adults
pregnant
children
Contributors
Authors
Miguel G. Madariaga, MD, MSc, FACP

Infectious Diseases Consultant
Naples Community Hospital
Naples
FL
Disclosures
MGM declares that he has no competing interests.
Peer reviewers
Fabrizio Bruschi, MD
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 topic.
Jean Dupouy-Camet, MD, PhD
Chef du Service de Parasitologie-Mycologie
Hôpital Cochin
Paris
France
Disclosures
JDC is an author of a number of references cited in this topic. JDC declares that he has no competing interests.
Christopher D. Huston, MD
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.
References
Key articles
Gottstein B, Pozio E, Nockler K. Epidemiology, diagnosis, treatment, and control of trichinellosis. Clin Microbiol Rev. 2009;22:127-45.Full text Abstract
Centers for Disease Control and Prevention. Trichinellosis (trichinosis): clinical overview of trichinellosis. May 2024 [internet publication].Full text
Dupouy-Camet J, Murrell KD, eds. FAO/WHO/OIE guidelines for the surveillance, management, prevention and control of trichinellosis. 2007 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Bacterial gastroenteritis
- Respiratory or gastrointestinal viral infections
- Glomerulonephritis
More DifferentialsGuidelines
- International Commission on Trichinellosis: recommendations on the use of serological tests for the detection of Trichinella infection in animals and humans
- FAO/WHO/OIE guidelines for the surveillance, management, prevention and control of trichinellosis
More GuidelinesPatient information
Diarrhea in adults
Diarrhea in children
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