An Outbreak of Human Trichinellosis in the Village of Subotinac near the Town of Aleksinac - - - Epidemija humane trihineloze u selu Subotinac u okolini Aleksinca
Journal Title: Acta Facultatis Medicae Naissensis - Year 2018, Vol 35, Issue 2
Abstract
An outbreak of trichinellosis affecting 13 individuals, of whom 8 with severe form presented as myocarditis, occurred in the village of Subotinac near the town of Aleksinac in Serbia. The source of this epidemic was smoked pork from a domestic pig that had not undergone meat inspection procedures. The most striking clinical features among all the 13 patients were muscular pain (84.6%), malaise (69.2%), upper eyelid edema (61.5%), and difficulty in chewing (53.9%). These symptoms and signs were associated with significant elevations of creatine phosphokinase and lactate dehydrogenase levels. As high as 61.5% of the patients with trichinellosis were diagnosed with myocarditis (determined by means of electrocardiography, echocardiography, troponin I and creatine kinase-MB measurements). The patients had Trichinella-specific IgG antibodies in an enzyme-linked immunosorbent assay and positive indirect immunofluorescence test results. Patients seemed to respond well to treatment with mebendazole. Corticosteroid therapy was administered to patients with myocarditis. Since high percentage of our patients presented with myocarditis, an infectious diseases specialist should always keep in mind doing cardiac biomarkers analyses, echocardiography and electrocardiography. - - - U selu Subotinac, blizu grada Aleksinca, došlo je do epidemije trihineloze, od koje je obolelo trinaestoro osoba, od kojih je osmoro razvilo ozbiljnu formu bolesti u vidu miokarditisa. Izvor epidemije bila je dimljena svinjetina poreklom od domaće svinje koja nije podlegla procedurama provere mesa. Dominantni klinički znaci i simptomi kod ovih trinaestoro bolesnikabili su: bol u mišićima (84,6%), malaksalost (69,2%), otok gornjih kapaka (61,5%) i otežano žvakanje (53,9%). Pomenuti znaci i simptomi bili su udruženi sa značajno povišenom aktivnošću kreatin fosfokinaze i laktat dehidrogenaze. Kod čak 61,5% bolesnika sa trihinelozom utvrđen je miokarditis (prema nalazima elektrokardiografije, ehokardiografije, te nivoima troponina I i kreatin kinaze-MB). Kod pacijenata su bila prisutna Trichinella-specifična IgG antitela imunoenzimskog testa i pozitivni rezultati testa indirektne imunofluorescencije. Odgovor bolesnika na terapiju mebendazolom bio je zadovoljavajući. Kortiko-steroidna terapija ordinirana je bolesnicima sa miokarditisom. S obzirom da je kod visokog procenta naših bolesnika bio prisutan miokarditis, infektolozi bi uvek trebalo da imaju u vidu upotrebu analiza srčanih bio-markera, ehokardiografije i elektrokardiografije.
Authors and Affiliations
Lidija Popović-Dragonjić, Ilija Kocić
Keywords
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- EP ID EP349425
- DOI 10.2478/afmnai-2018-0016
- Views 103
- Downloads 0
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