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February 19, 1982

Fatal CNS Trichinosis

JAMA. 1982;247(7):1024-1025. doi:10.1001/jama.1982.03320320060034

CENTRAL nervous system involvement by trichinosis has been recognized since the early part of this century.1 The reported incidence of trichinosis in the United States now averages less than 150 cases a year.2 Because only a small percentage of infected patients have CNS involvement, many physicians might fail to recognize this entity. We report the case of a patient who died of CNS trichinosis.

Report of a Case  A 50-year-old woman from southwestern Louisiana was in excellent health until late April 1980, when intermittent diarrhea and nausea developed. On May 13, she noted headache, photophobia, myalgias, and periorbital edema. She was admitted to a local hospital with a temperature of 39.5 °C and a WBC count of 12,800/cu mm, with 10% eosinophils. Dexamethasone therapy for a presumed allergic reaction resulted in improvement. When the dexamethasone administration was discontinued after ten days, fever and myalgias returned. Seizures and a