The "starry night" (diffuse microcalcific myopathy) - thousands of muscle microcalcifications after 30 years of Trichinella infection detected by ultrasound.

Trichinellosis, a parasitosis transmitted through consumption of raw or undercooked meat from pigs and game animals, is responsible for a specific myositis. The calcifications of infected myocytes and larva can be detected during many years postin-fection. We present the case of a male patient with a history of severe trichinellosis with disease onset 30 years ago, presenting with generalized muscle microcalcifications detected during musculoskeletal ultrasound evaluation. The ultrasound aspect of the muscles was indeed spectacular; hence, the comparison with a "starry night".

Diffuse 18F-FDG Muscle Uptake in Trichinella spiralis Infection.

Two patients were referred to our emergency department with myalgia, fever, general malaise, eosinophilia, and elevated serum levels of creatine kinase and troponin T. 18F-FDG PET/CT scan was performed showing a diffuse and homogenous moderately elevated glucose uptake in all muscle groups. Trichinella spiralis infection was confirmed by a muscle biopsy and detection of trichinella antibodies. The muscle biopsy was taken in the left quadriceps because of equal involvement of the skeletal muscles. The differential diagnosis of diffuse 18F-FDG muscle uptake should include trichinella infection, in particular, in the presence of infectious symptoms, eosinophilia, and biochemical signs of muscle damage.

[The ability of 67Ga scintigraphy to detect Trichinella spiralis]. / Trichinella spiralis'in Tanisinda Gallium-67 Sintigrafisinin Yeri.

To assess the value of (67) Ga scintigraphy in the lesions of Trichinella spiralis, an animal model was developed. Three infected and five healthy animals were enrolled in this study. After the injection of 7.4 MBq (200 micro Ci) (67) Ga citrate intravenously, static images from whole body were obtained at 24(th), 48 (th) and 72 (nd) hours Visual and semiquantitative analyses were performed. In semiquantitative analysis, activity counts were calculated over the whole body, diaphragm, neck muscles and extremities muscles of all animals. Between the infected animals and control group, mean bodies activity ratios were compared as visually and statistically. (67) Ga scintigraphy can't successfully demonstrate the lesions of Trichinella spiralis.

Trichinosis: a prospective controlled study of patients ten years after acute infection.

The existence of chronic trichinosis as a disease entity is still a matter of debate. For 10 years after an outbreak of infection with Trichinella spiralis, we conducted a prospective controlled study of the patients involved. At the termination of this investigation, we undertook clinical, biochemical, serological, immunologic, neuroradiological, radiological, and psychological studies of 128 originally infected persons and 16 controls. The categories of symptoms most often documented in persons who had been infected were muscular (90%), ocular (59%), neurological (52%), and psychological (52%). Impaired muscle strength (56%), conjunctivitis (55%), and impaired coordination (32%) were the clinical manifestations most frequently encountered. Thirty-eight percent of the 128 originally infected patients still had IgG antibodies to T. spiralis after 10 years. Magnetic resonance imaging of the brain revealed no abnormalities. No calcifications of residual larvae were detected by mammography or muscle biopsy. The level of performance in psychometric tests was lower in the originally infected population than in the general population. Although patients who had had trichinosis differed significantly from controls in terms of a variety of parameters even after 10 years, we found insufficient evidence on which to conclude that chronic trichinosis exists as a distinct entity.

[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.

[X-ray manifestations of trichinosis on chest radiograph (analysis of 15 cases)].

This article reported the result of the chest radiographs of 14 patients with trichinosis, in regard to the X-ray manifestations, pathologic basis and clinical significance. The radiologic findings included hilar enlargement, exaggerated and fuzzy lung markings, and pulmonary patchy infiltrations of varying sizes as well as fine nodular shadows. The pathologic basis consisted of dilatation and congestion of pulmonary vessels and capillary beds and intrapulmonary hemorrhagic lesions. The pulmonary radiologic manifestations are helpful for estimating patient's prognosis.

Trichinosis diagnosed by computed tomography.

Trichinosis is a worldwide disease contained by good husbandry and culinary practice, presenting unexpectedly in individual cases or mini-epidemics. The disease varies greatly in its manifestation and severity although when marked can be recognized by fever with myositis and periorbital oedema. Antibody tests are specific but the appearance on computed tomography of the brain are sufficiently characteristic to allow a confident diagnosis. Two cases where such appearances led to the diagnosis are reported.

[Diagnosis and treatment of trichinosis by means of radionuclide]. / Diagnóstico y tratamiento de la triquinosis utilizando radionúclidos.

Using the same technique that gave such good results in cysticercosis and other parasitic diseases we obtained antibodies labelled against trichinosis and proved their diagnostic value by scan in infected rats. These same antibodies at lethal dose, median, (LD50) radiolysed trichina larvae without damage to the animal. Experimental results are very encouraging and their potential use in human subjects are undergoing research in our laboratory and will be the object of a future report.

[Parasitic calcifications: elements for diagnostic (author's transl)]. / Diagnostic des calcifications parasitaires (à l'exclusion des calcifications fongiques et des protozoaires)

Among the radiologic calcifications, those of parasitic etiology are rather commonly found. They are heterotopic dystrophic calcifications, their late apparition in the evolution of the parasitic disease is not subordinate to any metabolic dysfunction. The authors describe the morphologic and the topographic criteria of different parasitic calcifications except the fungic ones and protozoaire. Moreover they state for each parasite some epidemiological, biological and clinical facts which can be helpful for the diagnosis.