Triquinosis

Características Generales

Características básicas de la Trichinella Trichinella Trichinellosis is an illness caused by infection with Trichinella. The most common causative parasite is Trichinella spiralis, which is usually found in pigs and transmitted to humans through the ingestion of undercooked meat. Once ingested, the parasite grows and matures within the intestinal walls. Symptoms occur during larval migration. Trichinella/Trichinellosis

• Nematodo intestinal y tisular (vermes redondos)
• Parásito intracelular
• Enfermedad asociada: triquinosis o triquinelosis

Especies clínicamente relevantes

• La más relevante y con distribución a nivel mundial: Trichinella spiralis Trichinella spiralis A parasite of carnivorous mammals that causes trichinellosis. It is especially common in rats and in swine fed uncooked garbage. Human infection is initiated by the consumption of raw or insufficiently cooked pork or other meat containing the encysted larvae. Trichinella/Trichinellosis
• Causas de la triquinosis:
  • Encapsulamiento/enquistamiento (dentro de los LOS Neisseria músculos del huésped):
    • Trichinella Trichinella Trichinellosis is an illness caused by infection with Trichinella. The most common causative parasite is Trichinella spiralis, which is usually found in pigs and transmitted to humans through the ingestion of undercooked meat. Once ingested, the parasite grows and matures within the intestinal walls. Symptoms occur during larval migration. Trichinella/Trichinellosis britovi (Europa, Asia ASIA Spinal Cord Injuries y norte y oeste de África)
    • Trichinella Trichinella Trichinellosis is an illness caused by infection with Trichinella. The most common causative parasite is Trichinella spiralis, which is usually found in pigs and transmitted to humans through the ingestion of undercooked meat. Once ingested, the parasite grows and matures within the intestinal walls. Symptoms occur during larval migration. Trichinella/Trichinellosis murelli (América del Norte)
    • Trichinella Trichinella Trichinellosis is an illness caused by infection with Trichinella. The most common causative parasite is Trichinella spiralis, which is usually found in pigs and transmitted to humans through the ingestion of undercooked meat. Once ingested, the parasite grows and matures within the intestinal walls. Symptoms occur during larval migration. Trichinella/Trichinellosis nativa (Ártico)
    • Trichinella Trichinella Trichinellosis is an illness caused by infection with Trichinella. The most common causative parasite is Trichinella spiralis, which is usually found in pigs and transmitted to humans through the ingestion of undercooked meat. Once ingested, the parasite grows and matures within the intestinal walls. Symptoms occur during larval migration. Trichinella/Trichinellosis nelsoni (África oriental)
  • No encapsulados:
    • Trichinella Trichinella Trichinellosis is an illness caused by infection with Trichinella. The most common causative parasite is Trichinella spiralis, which is usually found in pigs and transmitted to humans through the ingestion of undercooked meat. Once ingested, the parasite grows and matures within the intestinal walls. Symptoms occur during larval migration. Trichinella/Trichinellosis papuae (Papúa Nueva Guinea)
    • Trichinella Trichinella Trichinellosis is an illness caused by infection with Trichinella. The most common causative parasite is Trichinella spiralis, which is usually found in pigs and transmitted to humans through the ingestion of undercooked meat. Once ingested, the parasite grows and matures within the intestinal walls. Symptoms occur during larval migration. Trichinella/Trichinellosis pseudospiralis (a nivel mundial)
    • Trichinella Trichinella Trichinellosis is an illness caused by infection with Trichinella. The most common causative parasite is Trichinella spiralis, which is usually found in pigs and transmitted to humans through the ingestion of undercooked meat. Once ingested, the parasite grows and matures within the intestinal walls. Symptoms occur during larval migration. Trichinella/Trichinellosis zimbabwensis (Tanzania)

Epidemiología

• Se calcula que cada año se producen 10 000 casos de triquinosis a nivel mundial.
• En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum Estados Unidos:
  • 15 casos por año
  • Hubo una disminución de los LOS Neisseria casos debido a la mejora de la producción porcina
• Existe una alta prevalencia en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum:
  • China
  • Antigua Unión Soviética
  • Rumania y otras partes de Europa Central
  • Tailandia
  • México
  • Argentina
  • Bolivia

Fisiopatología

Reservorios y transmisión

• Reservorios:
  • Trichinella spiralis Trichinella spiralis A parasite of carnivorous mammals that causes trichinellosis. It is especially common in rats and in swine fed uncooked garbage. Human infection is initiated by the consumption of raw or insufficiently cooked pork or other meat containing the encysted larvae. Trichinella/Trichinellosis: cerdos/porcinos
  • Otros animales: jabalíes, osos, roedores, caballos, alces
• Transmisión: carne cruda o poco cocinada (especialmente de cerdo y de oso) que contiene larvas

Patogénesis

• Las larvas enquistadas viven dentro de los LOS Neisseria músculos estriados del animal reservorio (algunas especies no están enquistadas).
• Las larvas se ingieren cuando se consume carne poco cocinada.
• Fase gastrointestinal:
  • Tras la exposición al AL Amyloidosis ácido gástrico y la pepsina, las larvas se liberan de los LOS Neisseria quistes.
  • Las larvas invaden la mucosa del intestino delgado y luego se convierten en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum vermes adultos.
  • Se produce el apareamiento; su vida en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el intestino delgado dura aproximadamente 4 semanas.
• Fase sistémica:
  • Las hembras liberan larvas que entran en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la circulación.
  • Las larvas migran a los LOS Neisseria músculos estriados.
  • La migración tisular puede durar hasta 1 mes, causando síntomas.
  • Los LOS Neisseria siguientes músculos altamente activos se ven afectados:
    • Diafragma
    • Lengua
    • Masetero
    • Intercostales
    • Músculos extraoculares
  • Pueden alcanzar el miocardio y el cerebro, y provocar una reacción inflamatoria cardíaca y cerebral.
  • A medida que las larvas se enquistan, se produce una infiltración tisular (por PMN y eosinófilos) y edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema.
  • La calcificación sigue después de varios meses y, posteriormente, permanecen en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum ese estado durante años, pero los LOS Neisseria síntomas disminuyen después de meses.

Presentación Clínica

• Características generales:
  • Periodo de incubación: 1–6 semanas
  • La gravedad de los LOS Neisseria síntomas depende de la cantidad de larvas (dosis infecciosa) consumida.
  • Dos fases: intestinal y sistémica
• Fase intestinal:
  • 2–7 días después de la exposición
  • Puede ser asintomática
  • Dolor Dolor Inflammation abdominal (mesogastrio)
  • Diarrea
  • Náuseas
  • Vómitos
• Fase sistémica:
  • 1–2 semanas después de la ingestión
  • Puede durar hasta 8 semanas
  • Fiebre y escalofríos
  • Edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema periorbital Periorbital Orbital and Preseptal Cellulitis/ edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema palpebral:
    • Proptosis Proptosis Retinoblastoma
    • Quemosis
    • Conjuntivitis
  • Mialgia:
    • Cara
    • Tórax
  • Debilidad
  • Tos TOS Thoracic outlet syndrome (TOS) is a broad term used for a spectrum of syndromes related to the general region of the thoracic outlet, which involves the compression or irritation of elements of the brachial plexus, subclavian artery, or subclavian vein. Thoracic Outlet Syndrome seca
  • Hemorragia en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum astilla y/o hemorragia retiniana
  • Erupción petequial/ urticaria Urticaria Urticaria is raised, well-circumscribed areas (wheals) of edema (swelling) and erythema (redness) involving the dermis and epidermis with associated pruritus (itch). Urticaria is not a single disease but rather is a reaction pattern representing cutaneous mast cell degranulation. Urticaria (Hives)
  • Cefalea
  • Hepatomegalia

Complicaciones

• Miocarditis:
  • El paso transitorio de células conlleva a la infiltración de células inflamatorias.
  • Las arritmias son la causa más común de muerte.
• Meningitis Meningitis Meningitis is inflammation of the meninges, the protective membranes of the brain, and spinal cord. The causes of meningitis are varied, with the most common being bacterial or viral infection. The classic presentation of meningitis is a triad of fever, altered mental status, and nuchal rigidity. Meningitis/encefalitis
• Pulmonares:
  • Neumonía bacteriana secundaria
  • Miositis respiratoria (que afecta al AL Amyloidosis diafragma)
• Insuficiencia renal
• Enfermedad tromboembólica

Diagnóstico

Pruebas diagnósticas

• Pruebas serológicas:
  • Solo detectable tras 3 semanas de incubación
  • Métodos utilizados:
    • Western blot
    • ELISA ELISA An immunoassay utilizing an antibody labeled with an enzyme marker such as horseradish peroxidase. While either the enzyme or the antibody is bound to an immunosorbent substrate, they both retain their biologic activity; the change in enzyme activity as a result of the enzyme-antibody-antigen reaction is proportional to the concentration of the antigen and can be measured spectrophotometrically or with the naked eye. Many variations of the method have been developed. St. Louis Encephalitis Virus
    • Inmunofluorescencia indirecta
    • Prueba de aglutinación en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum látex
• Biopsia muscular:
  • Lleva a un diagnóstico definitivo, pero se realiza solo si las pruebas iniciales no son concluyentes
  • Se realiza una biopsia del tejido muscular sintomático.
  • El examen mostraría un quiste de Trichinella spiralis Trichinella spiralis A parasite of carnivorous mammals that causes trichinellosis. It is especially common in rats and in swine fed uncooked garbage. Human infection is initiated by the consumption of raw or insufficiently cooked pork or other meat containing the encysted larvae. Trichinella/Trichinellosis incrustado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el tejido muscular.

Estudios adicionales

• Pruebas de laboratorio:
  • Hemograma
    • Eosinofilia
    • Leucocitosis
  • Panel metabólico y pruebas musculares:
    • Hipopotasemia
    • ↑ Creatina quinasa
    • ↑ Aminotransferasas
    • ↑ Lactato deshidrogenasa
    • ↑ Aldolasa
• Radiografía simple: calcificación intramuscular

Tratamiento

Tratamiento

• Infección leve: La mayoría de las infecciones no tienen complicaciones y son autolimitadas.
• En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum caso de infección con síntomas sistémicos, el tratamiento consiste en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum:
  • Medicamentos antiparasitarios:
    • Albendazol
    • Mebendazol
  • Corticosteroides (especialmente para las complicaciones graves)
• Prevención:
  • Cocinar la carne hasta los LOS Neisseria 77°C
  • Congelar la carne a -15°C (no aplicable a las especies del Ártico)
  • Manipulación adecuada de la carne
  • La profilaxis postexposición con mebendazol puede ser eficaz si se administra en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria 6 días siguientes a la exposición.

Pronóstico

• Autolimitado
• Recuperación completa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum 2–6 meses
• Aumento de la morbilidad con afectación cardíaca o del SNC

Diagnóstico Diferencial

• Gastroenteritis Gastroenteritis Gastroenteritis is inflammation of the stomach and intestines, commonly caused by infections from bacteria, viruses, or parasites. Transmission may be foodborne, fecal-oral, or through animal contact. Common clinical features include abdominal pain, diarrhea, vomiting, fever, and dehydration. Gastroenteritis: la fase intestinal de la triquinosis puede confundirse con una intoxicación alimentaria debido a los LOS Neisseria síntomas gastrointestinales constitucionales. Las causas virales y bacterianas de la gastroenteritis Gastroenteritis Gastroenteritis is inflammation of the stomach and intestines, commonly caused by infections from bacteria, viruses, or parasites. Transmission may be foodborne, fecal-oral, or through animal contact. Common clinical features include abdominal pain, diarrhea, vomiting, fever, and dehydration. Gastroenteritis deben considerarse y descartarse mediante los LOS Neisseria antecedentes, el examen físico y el análisis de las heces.
• Miopatías: Los LOS Neisseria trastornos autoinmunes como la polimiositis o la dermatomiositis se presentan con mialgias y síntomas y signos similares a los LOS Neisseria de la vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus, que son similares a los LOS Neisseria signos sistémicos de la triquinosis. Estos casos suelen afectar a los LOS Neisseria grupos musculares proximales, a diferencia de la triquinosis. Las investigaciones para detectar autoanticuerpos específicos, como los LOS Neisseria anticuerpos contra la proteína de reconocimiento de señal (anti-SRP, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés) y los LOS Neisseria anti-Mi2, ayudan al AL Amyloidosis diagnóstico. El tratamiento suele ser con inmunosupresores y glucocorticoides.
• Ascariasis Ascariasis Ascariasis is most often caused by A. lumbricoides. If symptomatic, characteristics typically follow 2 phases, which correlate with the migration of the parasite through the body. The early phase may include cough, dyspnea, and wheezing. The late phase typically includes abdominal discomfort, bloating, nausea, and intermittent diarrhea. Ascaris/Ascariasis: infección causada por el parásito Ascaris Ascaris Ascaris is a genus of parasitic nematodes. The infection, ascariasis, is most often caused by A. lumbricoides. Transmission occurs primarily via ingestion of water or food contaminated with Ascaris eggs. Most patients with ascariasis are asymptomatic. Ascaris/Ascariasis lumbricoides. La transmisión se produce por la ingestión de agua o alimentos contaminados. La mayoría de los LOS Neisseria pacientes son asintomáticos. Si se presentan síntomas, estos pueden ser leves, solo con molestias abdominales, o graves, provocando una obstrucción intestinal. Otros síntomas, como la tos TOS Thoracic outlet syndrome (TOS) is a broad term used for a spectrum of syndromes related to the general region of the thoracic outlet, which involves the compression or irritation of elements of the brachial plexus, subclavian artery, or subclavian vein. Thoracic Outlet Syndrome, se deben a la migración de los LOS Neisseria vermes por el cuerpo.
• Anquilostomiasis: causada por los LOS Neisseria helmintos Necator americanus Necator americanus A common parasite of humans in the moist tropics and subtropics. These organisms attach to villi in the small intestine and suck blood causing diarrhea, anorexia, and anemia. Hookworm Infections y Ancylostoma duodenale Ancylostoma Duodenale Hookworm Infections. Los LOS Neisseria pacientes presentarán anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types ferropénica y retraso en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el desarrollo. El diagnóstico implica la inspección de las heces humanas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum busca de larvas y huevos.
• Estrongiloidiasis: enfermedad causada por el verme redondo (nematodo) Strongyloides. La estrongiloidiasis tiene diversas manifestaciones clínicas, entre ellas síntomas gastrointestinales y eosinofilia. El diagnóstico se realiza a través de la serología.