240.2 📚 國考版

240.2.0.1 必背 — Trichinella spiralis

  • Undercooked pork + wild game (bear, boar)
  • 3 phases: intestinal → muscle invasion → convalescent
  • Classic triad: fever + myalgia + periorbital edema + eosinophilia
  • Elevated CK + LDH (muscle damage)
  • Severe: myocarditis (cause of death), encephalitis
  • Serology + clinical (muscle biopsy rare)
  • Treatment: Albendazole 400 mg bid × 8-14 d + prednisolone for severe

240.2.0.2 必背 — Trichinella nativa

  • Arctic + bear + walrus + freeze-resistant!
  • USA wild game cases
  • Cooking essential (freezing not reliable)

240.2.0.3 必背 — Anisakis

  • Raw saltwater fish (sushi, ceviche)
  • Acute gastric / intestinal pain + eosinophilia
  • IgE-mediated allergic reaction
  • Endoscopic removal definitive
  • Albendazole for residual

240.2.0.4 必背 — Gnathostoma

  • Raw freshwater fish (Asia — Thailand classic)
  • Migratory subcutaneous swellings + CNS + eye + eosinophilia
  • Albendazole + ivermectin

240.2.0.5 必背 — Angiostrongylus cantonensis

  • Slug / snail / contaminated produce / undercooked seafood
  • Hawaii + Caribbean + SE Asia endemic
  • Eosinophilic meningitis classic
  • CSF lymphocytic + eosinophilic pleocytosis
  • Supportive + steroid; albendazole controversial (may worsen CNS)

240.2.0.6 必背 — Toxocara

  • Dog / cat parasite eggs → soil → children
  • Visceral larva migrans (VLM) — pediatric, eosinophilia + hepatosplenomegaly + pneumonitis
  • Ocular larva migrans (OLM) — mimics retinoblastoma
  • Albendazole + steroid

240.2.0.7 必背 — Capillaria philippinensis

  • Raw freshwater fish (Asia)
  • Watery diarrhea + malabsorption + fatal untreated
  • Albendazole

240.2.0.8 必背 — Dracunculus (Guinea Worm)

  • WHO eradication near (< 30 cases/yr 2024+)
  • No drug; slow extraction
  • Education + water filtration

240.2.0.9 必背 — Prevention

  • Cook meat thoroughly (pork to 145°F internal)
  • Freeze fish for sushi (-20°C × 7 d per FDA)
  • Cook wild game thoroughly (T. nativa freeze-resistant!)
  • Avoid raw freshwater fish (Asia gnathostoma + capillaria)
  • Avoid slugs / contaminated raw produce in Angiostrongylus endemic
  • Educate children re soil contact (Toxocara)