Thursday, November 22, 2012
In Turkey, there was an outbreak of this disease in 98 patients. (It's Thanksgiving! Though in actuality, this disease is most prevalent in China, Thailand, Mexico, Argentina, and Bolivia). In the first week after exposure, patients complain of abdominal pain, nausea, vomiting, and diarrhea. Lab tests at this time are unrevealing.
After the first week, patients develop the cardinal symptoms of muscle pain, joint pain, and subjective muscle weakness. The most common muscle groups include the calves, upper arm, neck and shoulder girdle, and forearms. The pain can be so bad, patients do not want to move at all. On exam, they can have fever, subungual splinter hemorrhages, conjunctival or retinal hemorrhages, periorbital edema or chemosis, visual disturbances, and ocular pain. Lab tests show leukocytosis and eosinophilia (which peaks in the third or fourth week of disease). A light micrograph of a muscle biopsy is shown below.
First image is in the public domain, second image is shown under Fair Use.