© 2021 C. Nemet et al. This is an open access article licensed under the Creative Commons Attribution-
NonCommercial-NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/4.0/)
https://doi.org/10.2478/9788395815065-008
Diagnostic algorithm in human trichinellosis - premise of
avoiding complications and chronicity of the disease
Codruta NEMET
Transilvania University of Brasov, Romania
codruta_nemet@yahoo.com
Cristina DOBRESCU
Transilvania University of Brasov, Romania
cristina.dobrescu@ymail.com
Angela REPANOVICI
Transilvania University of Brasov, Romania
arepanovici@unitbv.ro
Abstract. Aim of the study: a systematic review of the scientific literature that contains
theoretical information about the infection with Trichinella species in humans. The research
questions were formulated, the criteria for inclusion and exclusion of the revised studies and
the search strategy were established, the studies were selected, the data were extracted and
finally the analysis and interpretation of the results was performed, all with the aim to establish
a diagnostic algorithm for patients with the suspected trichinellosis. From 312 existing studies,
300 that did not meet the inclusion criteria were excluded. The theoretical aspects studied refer
to the clinical and laboratory criteria that validate the diagnosis of trichinellosis in humans and
focus less on the elements of differential diagnosis, which would facilitate early diagnosis and
allow the establishment of specific antiparasitic treatment removing the spectrum of
complications or progression to chronicity of the disease.
Keywords: systematic review, trichinellosis, scientific literature.
Introduction
Trichinellosis is a zoonosis that is frequently found in the sylvatic, peridomestic and
domestic environment, in animals such as bears, wild boars, foxes, field rats and pigs
from households or from small animal farms. The disease is transmitted to humans by
eating pork or game meat infected with the Trichinella spiralis parasite, which is
incompletely or incorrectly heat-treated (Gottstein et al. 2009). In humans, the disease
has a tropism for striated muscles, where the parasite, after a long process of evolution,
can survive up to 40 years (Fröscher et al. 1988). Undiagnosed trichinellosis and
therefore untreated in a timely manner can progress chronically, socially and
professionally incapacitating the patient. Hence the importance of an early diagnosis
of human trichinellosis, which will mean the inactivation of the parasite in the circulatory
spread phase of the diseases or in the beginning of its encystment (Dupouy-Camet et
al. 2007, Gottstein et al. 2009).
In humans, the Trichinella spiralis parasite goes through 3 stages from infection to
encapsulation. The first enteral phase begins with the ingestion of infected meat. In the
stomach of the new host the larvae become free and pass very quickly into the small
intestine, where it finds both food and oxygen necessary for their growth and
development. The larvae deposited by the females of the parasite spread through the
circulatory system, throughout the body, in their migration to the striated muscle. The