Trichinosis differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Danitza Lukac


Trichinosis must be differentiated from influenza virus, salmonella, shigella, eosinophilia-myalgia syndromes, tissular parasitosis, glomerulonephritis, serum sickness, infectious meningitis and encephalitis, leptospirosis, bacterial endocarditis and typhus exanthematicus.[1]

Differentiating Trichinosis from other Diseases

Differentiating Trichinosis from other Diseases[1]
Differential Diagnosis Similar Clinical Features Distinguishing Clinical Features
  • Influenza virus
High fever + myalgia No eosinophilia
  • Salmonella
  • Shigella
Protracted diarrhoea No eosinophilia
Eosinophilia-Myalgia Syndromes:
  • Toxic Oil Syndrome
  • Tryptophan Intake
  • Eosinophilic Fasciitis
Eosinophilia + myalgia + inflammatory response History of L-tryptophan ingestion
  • Fascioliasis
  • Toxocariasis
  • Invasive Schistosomiasis
Eosinophilia + fever
  • Fascioliasis: Latent phase after symptoms start
  • Toxocariasis: Elevation of anti-A, anti–B isohaemagglutinins
  • Invasive Schistosomiasis: Itchy + papular rash
  • Glomerulonephritis
  • Serum Sickness
  • Allergic reactions to drugs or allergens
  • Polymyositis
  • Dermatomyositis
  • Periarteritis Nodosa
Periorbital or facial edema + fever
  • Glomerulonephritis: Hematuria + foamy urine
  • Serum Sickness: Due to an antiserum derived from an animal source
  • Polymyositis: Weakness and/or loss of muscle mass in the proximal musculature + dysphagia + foot drop
  • Dermatomyositis: Symmetric proximal muscle weakness + Gottron's sign + heliotrope + Shawl (or V-) sign + Erythroderma
  • Periarteritis Nodosa: Nodules in the lower legs + nerve involvement (numbness, pain, burning, and weakness) + Livedo reticularis
  • Leptospirosis
  • Bacterial Endocarditis
Haemorrhages of the conjunctiva or haemorrhagic skin petechiae + fever
  • Leptospirosis: Jaundice + asymptomatic phase (3–4 days) after symptoms start
  • Bacterial Endocarditis: Osler nodes, Janeway lesion


  1. 1.0 1.1 FAO/WHO/OIE Guidelines for the surveillance, management, prevention and control of trichinellosis. FAO (2007). Accessed on January 28, 2016