The use of prednisone in the treatment of trichineliosis

Zvi Shimoni, Zeev Klein, Paltiel Weiner, Marc Victor Assous, Paul Froom

Research output: Contribution to journalArticlepeer-review

Abstract

Background: it is not entirely clear when and how steroids should be used to treat trichinellosis. Objectives: To describe the course of consecutive patients with trichinellosis treated with antihelminthic drugs with and without the addition of prednisone. Methods: We extracted data from the hospital records of 30 patients hospitalized for trichinellosis contracted after eating poorly cooked pork that came from two wild pigs killed in the Golan Heights, and contacted them for follow-up 5-6 weeks and 6 months after hospital discharge. Results: All the patients who attended a party and ingested the infected pork (100% attack rate) were hospitalized after 2-16 days (median 9 days); 29 were symptomatic and 1 patient without symptoms had creatine phosphokinase levels 17.9 times above the upper limit of normal. Twelve of 23 patients (52%) treated with antihelminthic drugs without prednisone were rehospitalized with worsening fever, increased peripheral blood eosinophil counts, but decreasing CPK values. These patients and another seven at the time of admission were treated with prednisone 40 mg/day for 5 days in addition to antihelminthic drugs for at least 14 days. All became asymptomatic within 24 hours and were asymptomaric 6 weeks and 6 months later. Conclusions: Worsening symptoms in patients treated with antihelminthic drugs alone is common. A short course of prednisone is safe and alleviates symptoms due to tissue larvae in patients with trichinellosis.

Original languageEnglish
Pages (from-to)537-539
Number of pages3
JournalIsrael Medical Association Journal
Volume9
Issue number7
StatePublished - Jul 2007

Keywords

  • Pork
  • Prednisone
  • Symptoms
  • Trichinellosis
  • Worsening

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