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March 1964

Treatment of Trichinosis: Case Report

Author Affiliations

From the Wills Eye Hospital.; Chief Resident (Dr. Spaeth), and Assistant Resident (Dr. Adams), Wills Eye Hospital; Consultant in Medicine, Wills Eye Hospital, Instructor in Cardiology, University of Pennsylvania Graduate School of Medicine (Dr. Soffe).

Arch Ophthalmol. 1964;71(3):359-363. doi:10.1001/archopht.1964.00970010375011

The management of the patient with trichinosis has, in the past, been entirely symptomatic. No drug could kill the Trichinella spiralis worm once it had invaded the blood stream or muscles of the body. Adrenal cortical steroids were found to reduce the severity of the symptoms1 and have been widely used, especially in cases with myocarditis or encephalitis.2 In 1936, a total of 46% of patients with neurologic symptoms died of their illness, while in 1960, only 8% succumbed. The use of corticotropin (ACTH) or steroids probably helps account for this decrease in mortality. Intelligent use of supportive measures, such as electrolyte balance and assisted respiration, is also a factor.3 However, aside from the antiinflammatory action of steroids, one wonders about their beneficial effect, for they may permit the reproducing worm to live longer and to spew out an increased number of circulating and encysting larvae. Kagan

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