Incidental trichinellosis of strap muscle identified after thyroglossal duct cyst excision.

OBJECTIVES (1) Present a unique case of a thyroglossal duct cyst (TGDC) excised for recurrent infections with Trichinella spiralis in adjacent strap muscle; (2) review the literature regarding the diagnosis and treatment of subclinical trichinellosis of the head and neck. STUDY DESIGN Case report and literature review. METHODS Case report and literature review. RESULTS We present the case of a male immigrant who suffered from recurrent midline neck infections due to aTGDC. The patient underwent an uneventful Sistrunk procedure. Histological examination of the surgical specimen revealed a chronically infected TGDC as well as remnants of skeletal muscle adjacent to the cyst containing nematode larvae, positively identified as Trichinella spiralis. The patient was subsequently evaluated by an infectious disease specialist and required no further treatment for his parasitic infection. DISCUSSION The presence of nematode infections in developed countries is rare today given improved hygiene practices and control of meat quality. We present a unique case of incidentally noted Trichinella spiralis infection of the head and neck. To our knowledge, this is the first described case of trichinellosis of strap muscle adjacent to an excised TGDC and furthermore highlights the rarity of Trichinella spiralis infections of the head and neck. CONCLUSIONS Trichinella spiralis may exist subclinically in a variety of human tissues including neck muscles.