[Neurologic manifestations in trichinosis]. / Neuroloske manifestacije u toku trihinoze.

Neurologic manifestations are present in about 10-20 percent of patients with trichinosis. They could be a serious diagnostic problem in the absence of corresponding epidemiological data and typical symptoms and signs of the disease. In untreated patients the mortality rate is about 50%. Several pathogenic mechanisms are responsible for the neurological complications in trichinosis: obstruction of brain blood vessels by larvae, cysts or granulomas, toxic vasculitis with secondary thrombosis and haemorrhages, granulomatous inflammation of the brain parenchyma and allergic reaction. Neurotrichinosis is manifested with clinical symptoms and signs of meningitis, encephalitis, polyradiculoneuritis, poliomyelitis, myastenia gravis, paresis and paralysis, with the clinical picture of systemic disease of the connective tissue involving the nervous system and, extremely rare, as a sinus thrombosis. Thus, the broad spectrum of neurological lesions in trichinosis is, probably, the results of the fact that Trichinella spiralis larvae, during haematogenic dissemination has no special affinity for particular parts of the nervous system. We present five patients with encephalitis and focal cerebral lesions in trichinosis. In one patient the neurologic manifestations were the only sign of the disease. We believe that all pathogenic mechanisms mentioned above, were involved in the onset of neurological manifestations in our patients. The diagnosis of the disease was based on the clinical picture, epidemiological data, microscopic identification of larvae in the muscular tissue, the presence of antibodies against Trichinella spiralis in cerebrospinal fluid (with preserved blood brain barrier) and in serum confirmed by IIF method, computerised tomography and magnetic resonance imaging of the brain, eosinophilia in the peripheral blood picture. One patient died, and in the remaining patients the course of the disease was favourable; they were discharged from the hospital with minimal neurologic sequelae.

[Cardiac trichinosis--echocardiographic study]. / Trihinoza srca--ehokardiografska studija.

Trichinosis is an intestinal and tissue infection of man caused by Trichinella spiralis. The most frequent and serious complication is myocarditis. M-mode and two-dimensional echocardiographic studies were carried out on 16 patients with clinical manifestation of trichinosis. The parameters of the left ventricular function, measured by echocardiography were examined, and the results were compared with the same parameters in 50 normal individuals. In 11 patients a variety of morphologic findings, like pericardial effusion, adhesions, focal endomyocardial fibrosis, dilated left ventricular cavity, were found. In one patient intra cavitary thrombus was bound. Pathologic parameters of the left ventricular function were registered in 15 patients.