Clinical aspects of chronic trichinellosis in people. III. Analysis of clinical and anatomopathologic diagnoses of cases in which Trichinella infection was detected in post-mortem examinations

Case records and post-mortem protocolls were analysed in 53 cases of persons who died because of various reasons and were found in post-mortem examinations to harbour in their muscles T. spiralis larvae, although the majority of the available records contained no mention on this subject. Analysing the main reason of death we found an unexpectedly high number of malignant tumors (14 out of 53) and still higher of circulatory disorders (22 out of 53). The problem of tumors is raised and discussed shortly in the light of literature data, more attention being paid to the question of circulatory diseases. It appers that previous Trichinella infection (even years ago) may contribute to permanent myocardial lesions, heart infarcts, aterosclerosis ect. Particular attention is deserved by case No. 1 concerning a patient who at the age of 46 years developed a chronic endocarditis with heart defect and chronic myocarditis, leading to death in the 59th year of life. As indicated by post-mortem anamnesis from the family members the heart ailments began after the regression of a disease, which was highly suggestive of trichinellosis, though at that time it was diagnosed as influenza. The same symptoms were exhibited simultaneously by her 2 daughters who after years showed a positive allergic test with T. spiralis antigen and signs characteristic of mitral defect. Assuming a genetically determined "topography" of predisposition for inflammator changes, in our case in the endocardium, we have advanced a hypo thesis that chronic trichinellosis may also contribute to the occurrence of acquired heart defects.