Trichostrongylus species are nematodes (round worms), which are ubiquitous among herbivores worldwide, including cattle, sheep, donkeys, goats, deer, and rabbits. At least 10 Trichostrongylus species have been associated with human infections. Infections occur via ingestion of infective larvae from contaminated vegetables or water. Epidemiological studies indicate a worldwide distribution of Trichostrongylus infections in humans, with the highest prevalence rates observed in individuals from regions with poor sanitary conditions, in rural areas, or who are farmers / herders. Human infections are most prevalent in the Middle East and Asia, with a worldwide estimated prevalence of 5.5 million people. Life cycle
Eggs are passed through the feces of an infected definitive host, usually a mammalian herbivore including rabbits, sheep, cattle, and rodents. Under certain environmental conditions, which include optimal temperature and humidity, larvae hatch from eggs after several days. Hatched rhabditiform larvae grow on vegetation or within soil. After 5 to 10 days, two molts (L1 & L2) have occurred and the parasite becomes a filariform (L3) larvae that is infectious. Infection in mammals occurs upon ingestion of infective filariform (L3) larvae. The larvae reaches the small intestine to reside and mature into adult worms within their definitive hosts. Infections in humans may occur as incidental infections. Trichostrongylus consists of multiple species that relate to each of its host, when it comes to parasitic survival and infection. For example, Trichostrongylus affinis primarily infects cottontail rats, Trichostrongylus sigmodontis affects hispid cotton rat, and marsh rice rat, and Trichostrongylus retortaeformis primarily affects European rabbits (Oryctolagus cuniculus).
High risk: bodybuilding, weightlifting (non-free and free weights), ice hockey, rock climbing, windsurfing, surfing, and scuba diving. Medication
Management often includes the use of beta blockers such as propranolol or if not tolerated calcium channel blockers or ACE inhibitors. Beta blockers are used to reduce the stress exerted on the aorta and to decrease aortic dilation. Surgery
If the dilation of the aorta progresses to a significant-diameter aneurysm, causes a dissection or a rupture, or leads to failure of the aortic or other valve, then surgery (possibly a composite aortic valve graft or valve-sparing aortic root replacement) becomes necessary. Although aortic graft surgery (or any vascular surgery) is a serious undertaking it is generally successful if undertaken on an elective basis. Surgery in the setting of acute aortic dissection or rupture is considerably more problematic. Elective aortic valve/graft surgery is usually considered when aortic root diameter reaches 50 millimeters (2.0 inches), but each case needs to be specifically evaluated by a qualified cardiologist. New valve-sparing surgical techniques are becoming more common. As people with Marfan syndrome live longer, other vascular repairs are becoming more common, e.g., repairs of descending thoracic aortic aneurysms and aneurysms of vessels other than the aorta.The skeletal and ocular manifestations of Marfan syndrome can also be serious, although not life-threatening. These symptoms are usually treated in an appropriate manner for the condition, such as with pain medications or muscle relaxants.