The use of prednisone in the treatment of trichinellosis.
BACKGROUND
It is not entirely clear when and how steroids should be used to treat trichinellosis.


OBJECTIVE
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 asymptomatic 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.
Shimoni
Zvi
Z
Infections Disease Unit, Department of Internal Medicine B, Laniado Hospital, Netanya, Israel.
Klein
Zeev
Z
Weiner
Paltiel
P
Assous
Marc Victor
MV
Froom
Paul
P
D000328:Adult; D015766:Albendazole / Q000627:therapeutic use; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use*; D003402:Creatine Kinase / Q000097:blood; D004359:Drug Therapy, Combination; D004804:Eosinophils / Q000166:cytology; D005334:Fever / Q000188:drug therapy / Q000469:parasitology; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008460:Meat / Q000469:parasitology; D008463:Mebendazole / Q000627:therapeutic use; D010359:Patient Readmission / Q000706:statistics & numerical data; D011241:Prednisone / Q000627:therapeutic use*; D013552:Swine / Q000469:parasitology; D014235:Trichinellosis / Q000188:drug therapy*
D000871:Anthelmintics; D005938:Glucocorticoids; D008463:Mebendazole; D003402:Creatine Kinase; D015766:Albendazole; D011241:Prednisone