Images in clinical medicine. The chemosis of trichinosis

A 45-YEAR-OLD MAN WAS ADMITTED TO THE HOSPITAL BECAUSE OF A FEVER (temperature, 40C), myalgia, and headache. He did not have diarrhea. On examination, he had bilateral proptosis with chemosis (Panel A) and eyelid edema. He had no trismus or sublingual splinter hemorrhages. The white-cell count was 17,500 per cubic millimeter, and the differential count included 14 percent eosinophils (2450 per cubic millimeter). The serum creatine kinase level was 651 U per liter (normal range, less than 170 U per liter).