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Trichinella larvae bury themselves inside muscle tissue rather than remain in the intestine as in other roundworm infections, so stool sample tests don't often show evidence of the parasite. The initial diagnosis relies on the classic signs and symptoms — swelling around the eyes, muscle inflammation and fever.
To confirm the diagnosis, your doctor might use these tests:
- Blood tests. Your doctor may take a blood sample and test it for signs suggesting trichinosis — an increase in the number of a certain type of white blood cell (eosinophils) or the formation of antibodies against the parasite after several weeks.
- Muscle biopsy. While the blood test typically is enough to establish a diagnosis, your doctor might also recommend a muscle biopsy. A small piece of muscle is removed and examined under a microscope to look for trichinella larvae.
Treatment
Trichinosis usually isn't serious and often gets better on its own, usually within a few months. However, fatigue, mild pain, weakness and diarrhea may linger for months or years. Symptomatic infections may respond to treatment with medication.
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Anti-parasitic medication. Anti-parasitic (anthelminthic) medication is the first line of treatment against trichinosis. If the trichinella parasite is discovered early, in the intestinal phase, albendazole (Albenza) or mebendazole can be effective in eliminating the intestinal worms and larvae. You may have mild gastrointestinal side effects during the course of treatment.
If the disease is discovered after the larvae bury themselves in tissues, the benefit of anti-parasitic medications is less certain. Your doctor might prescribe one if you have central nervous system, cardiac or respiratory problems as a result of the invasion
- Pain relievers. After muscle invasion, pain relievers may be given for muscle aches. Eventually, the larvae cysts in your muscles tend to calcify, resulting in destruction of the larvae and the end of muscle aches and fatigue.
- Corticosteroids. Some cases of trichinosis cause allergic reactions when the parasite enters muscle tissue or when dead or dying larvae release chemicals in your muscle tissue. Your doctor might prescribe a corticosteroid to control inflammation during larval migration.