Trichinellosis of the pharynx: causes, symptoms, diagnosis, treatment

Trichinellosis of the pharynx, like mycosis, is a parasitic disease of the pharynx, although the parasite itself belongs to the class of helminths from the nematode group. The disease is generally characterized by fever, damage to muscles, skin, mucous membrane of the upper respiratory tract, and in severe cases - internal organs and the central nervous system.

Cause. The causative agent is Trichinella spiralis. The length of the female is 3 mm, the male is 1-2 mm, both individuals reach 40 microns in diameter. Mature trichinella live in the mucous membrane of the large intestine. Females give birth to larvae, which are carried throughout the body by the blood and lymph flow and settle in the striated muscles, where they begin to curl into spirals and encapsulate 3-4 weeks after invasion. The capsule calcifies within 2 years, but the larvae can remain viable for 25 years.

Epidemiology. The source of infection for humans is pork, less often wild animals (wild boar, bears, walruses, seals, etc.) infected with trichinella and not properly cooked. Immunity after the disease is lifelong.

The clinical picture is diverse both in the severity of the disease and in the essence of the symptoms that arise, determined by the localization of the parasite invasion. The incubation period varies from 1 to 25 days. The disease begins suddenly with a rise in body temperature (38-40 ° C), swelling of the eyelids, muscle pain, eosinophilia up to 40% against the background of leukocytosis. Signs of the disease are nausea, vomiting, diarrhea, general poor condition, up to loss of consciousness, severe muscle pain, decreased muscle function (for example, dysfunction of the oculomotor muscles leads to temporary strabismus). Damage to the diaphragm and intercostal muscles greatly complicates respiratory movements, making them superficial and painful.

Trichinella can be carried with blood into the muscles of the pharynx and larynx and disrupt their motor function (dysphagia, dysphonia, pain when swallowing and talking). Foreign literature provides descriptions of several cases of trichinosis, in which temporary damage to the muscles of the tympanic cavity occurred, manifested by constant low-frequency tinnitus, autophony and hypoacusis.

In severe clinical cases, body temperature reaches 40-41°C, generalized muscle pain, insomnia, swelling of the face, neck, trunk, and limbs occur. A rash of erythematous-papular, sometimes hemorrhagic nature appears on the skin.

The prognosis with timely treatment is favorable.

The diagnosis is established based on the clinical picture (muscle pain, abdominal pain, diarrhea, muscle movement disorders, difficulty swallowing, hoarseness, eosinophilia and leukocytosis in the blood). Great importance is attached to the epidemiological anamnesis. If necessary, immunological diagnostic methods are used (indirect hemagglutination reaction with an antigen from trichinella larvae, complement fixation reaction, enzyme immunoassay).

Treatment of patients with mild and latent forms is carried out at home with symptomatic means (analgesics, antihistamines, easily digestible vitamin-rich food). In severe cases, treatment is carried out in hospital. Specific treatment with vermox (mebendazole), antihistamines, prednisolone is prescribed, and appropriate therapeutic measures are carried out if disorders of the internal organs occur.

Prevention includes public catering and individual measures.

The first is carried out in accordance with existing sanitary and anti-epidemic instructions under the supervision of sanitary and epidemiological supervision workers. Individual measures include not eating contaminated meat. In doubtful cases, it should be subjected to prolonged boiling for 2.1 / 2-3 hours with a piece no more than 2.5 cm thick. Trichinella larvae tolerate prolonged salting and smoking; in frozen meat at a temperature of - 15 - -20 ° C, they can remain viable for a long time.