Last reviewed: 21 Mar 2025
Last updated: 24 Jan 2025
Summary
Definition
History and exam
Key diagnostic factors
- consumption of raw or undercooked meat
- sick contacts
- myalgia and myositis
- fever
- periorbital/facial edema
- conjunctivitis and subconjunctival hemorrhages
Other diagnostic factors
- subungual and retinal splinter hemorrhages
- other ocular features
- gastrointestinal signs and symptoms
- hepatomegaly
- oliguria
- maculopapular rash
- other cutaneous features
- dysphagia
- dysphonia
- dyspnea
- headache
- paralysis-like state
- other neurologic features
Risk factors
- consumption of raw or undercooked pork
- consumption of raw or undercooked horse or other domestic animal meat
- consumption of raw or undercooked wild game meat
- consumption of raw or undercooked reptile meat
Diagnostic tests
1st tests to order
- CBC with differential
- creatine kinase and other muscle enzymes
- serum potassium
- serum albumin
- serum IgE
Tests to consider
- antibody serology
- muscle biopsy
- electromyography
- urinalysis
- serum creatinine and creatinine clearance
- serum aminotransferases
- MRI or CT brain
- EEG
- cerebrospinal fluid analysis
- ECG
- serum troponin
- Two-dimensional echocardiography
Treatment algorithm
Contributors
Authors
Miguel G. Madariaga, MD, MSc, FACP

Infectious Diseases Consultant
Naples Community Hospital
Naples
FL
Disclosures
MGM declares that he has no competing interests.
Peer reviewers
Fabrizio Bruschi, MD
Professor of Parasitology
Department of Experimental Pathology BMIE
Faculty of Medicine and Surgery
University of Pisa
Pisa
Italy
Disclosures
FB is an author of a number of references cited in this topic.
Jean Dupouy-Camet, MD, PhD
Chef du Service de Parasitologie-Mycologie
Hôpital Cochin
Paris
France
Disclosures
JDC is an author of a number of references cited in this topic. JDC declares that he has no competing interests.
Christopher D. Huston, MD
Associate Professor
Division of Infectious Diseases
Department of Medicine
University of Vermont College of Medicine
Burlington
VT
Disclosures
CDH declares that he has no competing interests.
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