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TRICHINELOZA

TRICHINELOZA. Defini ţ ie : - boal ă infec ţ ioas ă acut ă, - determinat ă de nematodul Trichinella spiralis - manifestat ă prin : - febr ă, - mialgii , - fenomene alergice. ETIOLOGIE. Vierme nematod, de 1,5-4 cm Genul Trichinella, familia Trichinelliadae.

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TRICHINELOZA

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  1. TRICHINELOZA • Definiţie: - boalăinfecţioasăacută, - determinată de nematodulTrichinellaspiralis - manifestatăprin: - febră, - mialgii, - fenomenealergice.

  2. ETIOLOGIE • Vierme nematod, de 1,5-4 cm • Genul Trichinella, familia Trichinelliadae

  3. EPIDEMIOLOGIE • Ciclul biologic integral în aceeaşigazdă: - larveînchistate in carneainfestata->intestin - eliberarealarvelor -> adulti in 5-7 zile - fertilizare -> masculieliminati in scaun -> femelelevivipare intra in mucoasa -> depunlarve (1500/1 femela) -> vase limfatice -> canal toracic -> sange -> tesuturi

  4. Tropisme: muschii striati - > chiste (50 zile-3 luni) • Gazde: - porc mistret - urs, vulpe - caine, pisica - sobolani - cal

  5. PATOGENIE Larvele viabile ingerate - > stomac - > intestin - > se matureaza in adulti masculi, femele - > microlarve - > circulatia generala - > canal toracic - > muschi striati scheletici -> larvele se inchisteaza Larvele pot migra si in miocard, SNC, pulmon, unde nu se inchisteaza.

  6. PATOGENIE

  7. PATOGENIE • Miozita (si miocardita) • Capilarita alergica • Infiltrat Loffler • Fenomene-neuropsihice

  8. CLINICA TRICHINELOZEI • Dependenta de doza de larve ingerata • Incubatia: 2-28 de zile (in medie 9-14 zile) • Stadiul intestinal: - dureri abdominale - diaree - anorexie, greata

  9. CLINICA TRICHINELOZEI • Stadiu de invazie musculara: perioada de stare - 20 - 30 zile - mialgii, tumefactia maselor musculare (tumefiere dureroasa), algii oculare - dificultate la masticatie, respiratie, mers - hemoragii subconjunctivale, chemozis

  10. - Eruptii urticariene - Edeme periorbitare, ale fetei

  11. CLINICA TRICHINELOZEI - febra 38-40 grade C - tulburari neuro-psihice: - cefalee, ameteli - confuzie - meningism -> coma - tulburari respiratorii: - tuse - expectoratie hemoptoica

  12. CLINICA TRICHINELOZEI - miocardita: - tahicardie - tulburari de ritm (galop) - modificari EKG Convalescenta: - coincide cu inchistarea larvelor in muschi - retrocedarea treptata a semnelor clinice

  13. Forme clinice • Usoare • Medii • Severe: - cu toxemie - fenomene neuro-psihice

  14. COMPLICATII • Nervoase: encefalita, meningoencefalita • Cardiace: miocardita • Vasculare (flebite, arterite) Decesul: prin soc infectios, miocardita, insuficienta respiratorie, casectizare progresiva

  15. DIAGNOSTIC POZITIV • Laborator: leucocitoza cu eozinofilie -> 10-70% (din saptamana II-III -> 6 luni) • Reactii intradermice • Reactii serologice: - precipitare larvara - teste de floculare: - cu bentonita - rapida, pe lama - test de microfloculare pe lama - RFC, aglutinare pe lama cu trichina-latex - ELISA • Biopsie musculara: saptamana 3-4 • Teste enzimatice: CPK, LDH, TGO

  16. DIAGNOSTIC DIFERENTIAL • Afectiuni mialgice: gripa, infectia cu Coxsackie, leptospiroza • Stari febrile: septicemii • Afectiuni neurologice: polinevrita, meningoencefalita • Dermatomiozita, polimiozita • Boli cu eozinofilie si febra: boala Hodgkin, leucemia cu eozinofile, periarteita nodoasa

  17. TRATAMENT • Igieno-dietetic: • repaus, • dieta cu calorii multe • Stadiul intestinal: • purgative • Vermifuge, albendazol • Antihelmintic: tiabendazol (mintezol) • Corticoterapie • Antihistaminice • Tratament patogenetic

  18. PROFILAXIA • Controlul trichinoscopic al carnii date la consum • Aplicarea si respectarea masurilor sanitar veterinare de prevenire a infestarii animalelor • Distrugerea larvelor din carnea infestata prin pastrarea bucatilor de carne de cca 15 cm grosime la -25 o C, 20 de zile • Prelucrarea termica corecta la > 75 o C • Raportarea cazurilor la organele sanitare - > ancheta epidemiologica

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