-
Parasitology Research Feb 2021Paragonimiasis is a foodborne trematode infection that affects 23 million people, mainly in Asia. Lung fluke infections lead frequently to chronic cough with fever and...
Paragonimiasis is a foodborne trematode infection that affects 23 million people, mainly in Asia. Lung fluke infections lead frequently to chronic cough with fever and hemoptysis, and are often confused with lung cancer or tuberculosis. Paragonimiasis can be efficiently treated with praziquantel, but diagnosis is often delayed, and patients are frequently treated for other conditions. To improve diagnosis, we selected five Paragonimus kellicotti proteins based on transcriptional abundance, recognition by patient sera, and conservation among trematodes and expressed them as His-fusion proteins in Escherichia coli. Sequences for these proteins have 76-99% identity with amino acid sequences for orthologs in the genomes of Paragonimus westermani, Paragonimus heterotremus, and Paragonimus miyazakii. Immunohistology studies showed that antibodies raised to four recombinant proteins bound to the tegument of adult P. kellicotti worms, at the parasite host interface. Only a known egg antigen was absent from the tegument but present in developing and mature eggs. We evaluated the diagnostic potential of these antigens by Western blot with sera from patients with paragonimiasis (from MO and the Philippines), fascioliasis, and schistosomiasis, and with sera from healthy North American controls. Two recombinant proteins (a cysteine protease and a myoglobin) showed the highest sensitivity and specificity as diagnostic antigens, and they detected antibodies in sera from paragonimiasis patients with early or mature infections. In contrast, antibodies to egg yolk ferritin appeared to be specific marker for patients with adult fluke infections that produce eggs. Our study has identified and localized antigens that are promising for serodiagnosis of human paragonimiasis.
Topics: Adult; Animals; Anthelmintics; Antibodies, Helminth; Antigens, Helminth; Asia; Gerbillinae; Humans; Immunohistochemistry; Paragonimiasis; Paragonimus; Paragonimus westermani; Praziquantel; Recombinant Proteins; Sensitivity and Specificity; Serologic Tests
PubMed: 33415393
DOI: 10.1007/s00436-020-06990-z -
PLoS Neglected Tropical Diseases Dec 2023Pulmonary paragonimiasis, a food-borne zoonotic helminthiasis, is a parasitic disease of the lung caused by infection with trematodes species of the genus Paragonimus....
BACKGROUND
Pulmonary paragonimiasis, a food-borne zoonotic helminthiasis, is a parasitic disease of the lung caused by infection with trematodes species of the genus Paragonimus. Although pneumothorax has been reported as occuring with paragonimiasis, to date no study has been performed concerning the clinical features and predictive risk factors for this condition.
METHODS
This retrospective study, which aims to fill this gap, was conducted at Jeonbuk National University Hospital. All patients (aged ≥19 years) were diagnosed with paragonimiasis between May 2011 and December 2021. Medical records were reviewed and information concerning age, sex, vital signs, underlying diseases, clinical signs and symptoms, laboratory findings, radiologic findings, treatment, and clinical outcomes was collected. An odds ratio (OR) for the risk factors associated with pneumothorax was calculated using the binary logistic regression model.
RESULTS
Among 179 consecutive patients diagnosed with pulmonary paragonimiasis, the postive rate of pneumothorax was 10.6% (19/179). Pneumothorax occurred mostly in the right lung (78.9%, 15/19), and intrapulmonary parenchymal lesions showed an ipsilateral relationship with pneumothorax (94.7%, 18/19). Fifteen patients (78.9%, 15/19) of pneumothorax associated with pulmonary paragonimiasis are accompanied by pleural effusion. Most of patients with pneumothorax (89.5%, 17/19) underwent chest tube insertion as a first treatment. Three patients (15.8%) showed relapses but in no case was a death recorded. Asthma (odds ratio [OR] 8.10, 95% confidence interval [CI] 1.43-45.91), chest pain (OR 8.15, 95% CI 2.70-24.58), and intrapulmonary lesions (OR 8.94, 95% CI 1.12-71.36) were independent risk factors for pulmonary paragonimiasis-associated pneumothorax.
CONCLUSIONS
Our findings suggest that clinicians should keep in mind the possibility of pneumothorax when approached by patients with pulmonary paragonimiasis complaining of chest pain, accompanied by intrapulmonary lesions or with asthma as an underlying disease.
Topics: Animals; Humans; Paragonimiasis; Pneumothorax; Retrospective Studies; Paragonimus; Risk Factors; Asthma; Chest Pain
PubMed: 38100524
DOI: 10.1371/journal.pntd.0011828 -
Iranian Journal of Parasitology 2023is a genus of parasitic flatworms known as lung flukes that cause the parasitic disease paragonimiasis in humans and other mammals. We aimed to use bibliometric...
BACKGROUND
is a genus of parasitic flatworms known as lung flukes that cause the parasitic disease paragonimiasis in humans and other mammals. We aimed to use bibliometric analysis to identify the global characteristics and temporal trends of published literature about paragonimiasis.
METHODS
Using the Web of Science database, we identified all original articles on paragonimiasis 1997 to 2022. After collecting the bibliographic and citation data, keywords, citation networks, and co-citations pertaining to paragonimiasis was carried out using the VOSviewer program.
RESULTS
The study identified 563 paragonimiasis articles published in 250 journals. Publications in paragonimiasis research have been cited 6190 times and 2803 times without self-citations. The years with the most publications were 2013, 2016, and 2021. The minimal threshold for analysis was met by 19 of the 52 countries investigated. The study included 19 items, yielding 170 links between countries. The total strength of these links was discovered to be 104772. The journal with the most publications in this category was Parasitology Research (n=31). The most frequently used terms in paragonimiasis study were "paragonimiasis", "", and "lung-fluke."
CONCLUSION
The study concluded by providing an overview of the paragonimiasis research field, including current trends, development, and researcher collaboration. By addressing gaps in this bibliometric analysis and increasing collaboration, stake-holders could strengthen their strategies to effectively combat paragonimiasis and improve public health outcomes.
PubMed: 37886253
DOI: 10.18502/ijpa.v18i3.13760 -
Parasitology Sep 2022The title of this article refers to Table 1 in Zhou (2022, Infectious diseases of poverty: progress achieved during the decade gone and perspectives for the future.... (Review)
Review
The title of this article refers to Table 1 in Zhou (2022, Infectious diseases of poverty: progress achieved during the decade gone and perspectives for the future. Infectious Diseases of Poverty 11, 1), in which it is indicated that species, like many other foodborne trematodes, are ancient pathogens that are also re-emerging to cause disease in modern times. This article provides a general overview of species and the disease they cause. This is followed by comments on several specific topics of current interest: taxonomy and distribution of members of the genus; details of the life cycle; global and regional prevalence of paragonimiasis; genomics of lung flukes and possible effects of global environmental change. Unresolved questions relating to these topics are discussed and gaps in knowledge identified.
Topics: Animals; Lung; Paragonimiasis; Paragonimus; Prevalence
PubMed: 35292126
DOI: 10.1017/S0031182022000300 -
PLoS Neglected Tropical Diseases Feb 2021Paragonimiasis is caused by zoonotic trematodes of Paragonimus spp., found in Asia, the Americas and Africa, particularly in tropical regions. These parasites have a... (Meta-Analysis)
Meta-Analysis
Endemicity of Paragonimus and paragonimiasis in Sub-Saharan Africa: A systematic review and mapping reveals stability of transmission in endemic foci for a multi-host parasite system.
Paragonimiasis is caused by zoonotic trematodes of Paragonimus spp., found in Asia, the Americas and Africa, particularly in tropical regions. These parasites have a complex, multi-host life cycle, with mammalian definitive hosts and larval stages cycling through two intermediate hosts (snails and freshwater decapod crustaceans). In Africa, paragonimiasis is particularly neglected, and remains the only human parasitic disease without a fully characterised life cycle. However paragonimiasis has potentially significant impacts on public health in Africa, and prevalence has likely been underestimated through under-reporting and misdiagnosis as tuberculosis due to a similar clinical presentation. We identified the need to synthesise current knowledge and map endemic foci for African Paragonimus spp. together with Poikilorchis congolensis, a rare, taxonomically distant trematode with a similar distribution and morphology. We present the first systematic review of the literature relating to African paragonimiasis, combined with mapping of all reported occurrences of Paragonimus spp. throughout Africa, from the 1910s to the present. In human surveys, numerous reports of significant recent transmission in Southeast Nigeria were uncovered, with high prevalence and intensity of infection. Overall prevalence was significantly higher for P. uterobilateralis compared to P. africanus across studies. The potential endemicity of P. africanus in Côte d'Ivoire is also reported. In freshwater crab intermediate hosts, differences in prevalence and intensity of either P. uterobilateralis or P. africanus were evident across genera and species, suggesting differences in susceptibility. Mapping showed temporal stability of endemic foci, with the majority of known occurrences of Paragonimus found in the rainforest zone of West and Central Africa, but with several outliers elsewhere on the continent. This suggests substantial under sampling and localised infection where potential host distributions overlap. Our review highlights the urgent need for increased sampling in active disease foci in Africa, particularly using molecular analysis to fully characterise Paragonimus species and their hosts.
Topics: Animals; Databases, Factual; Humans; Life Cycle Stages; Lung; Paragonimiasis; Paragonimus; Prevalence; Public Health; Snails
PubMed: 33544705
DOI: 10.1371/journal.pntd.0009120 -
Turkish Neurosurgery 2020To investigate the clinical manifestations and radiologic characteristics in diagnosing and treating hemorrhagic cerebral paragonimiasis. (Review)
Review
AIM
To investigate the clinical manifestations and radiologic characteristics in diagnosing and treating hemorrhagic cerebral paragonimiasis.
MATERIAL AND METHODS
The study retrospectively analyzed the data of three cases of hemorrhagic paragonimiasis who received treatment in the hospital from January 2014 to March 2017. All three patients were diagnosed with paragonimiasis by positive detection of paragonimiasis antibody. Based on the imaging data, the disease was confirmed as hemorrhagic cerebral paragonimiasis. One of the three patients was treated with oral praziquantel alone, one with praziquantel and thoracentesis, and one with praziquantel in combination with closed thoracic drainage and craniotomy.
RESULTS
All the lesions disappeared after computed tomography scan during the follow-up. Two of the three patients had no dysneuria, and one had mild dysneuria.
CONCLUSION
Hemorrhagic cerebral paragonimiasis should be diagnosed as early as possible using antibodies against paragonimiasis for patients with unexplained intracerebral hemorrhage, especially young patients with atypical imaging findings and multiple systemic lesions. It is possible to avoid craniotomy and improve the cure rate by the early, full-dose, and sufficient course of anti-parasitic treatment.
Topics: Cerebral Hemorrhage; Child; Combined Modality Therapy; Craniotomy; Humans; Male; Paragonimiasis; Praziquantel; Retrospective Studies; Tomography, X-Ray Computed; Young Adult
PubMed: 30984986
DOI: 10.5137/1019-5149.JTN.22666-18.3 -
Food and Waterborne Parasitology Mar 2023Infections with the lung fluke, have been diagnosed in a variety of domestic and wild animals and humans in USA and Canada. Although there are many species of in other... (Review)
Review
Infections with the lung fluke, have been diagnosed in a variety of domestic and wild animals and humans in USA and Canada. Although there are many species of in other parts of the world; is the only species definitively diagnosed in USA and Canada. Fresh water snails (several species) and crayfish (mainly spp.) are its intermediate hosts. Humans and animals become infected with only by ingesting metacercariae encysted in the heart of crayfish. After ingestion, the fluke penetrates intestinal wall, enters peritoneal cavity, and reaches pleural cavity by direct penetration of diaphragm, 2-3 weeks post inoculation (p.i.). Young flukes penetrate lungs and become encysted in pulmonary tissue, often in pairs. Time to maturity is around 4-7 weeks p.i. Eggs are coughed up, swallowed, and are excreted in feces. Although the parasite has been known for more than a century, there has been an upsurge of human infections in the USA. Here, I review infections in naturally infected hosts. Pathogenesis, diagnosis, and treatment in parasite-free cats and dogs experimentally infected are reviewed to shed light on the pathogenesis of human paragonimiasis. Problems and challenges facing diagnosis of paragonimiasis, especially non-pulmonary infections, are discussed. Fluke stages are deposited in Smithsonian Museum.
PubMed: 36588917
DOI: 10.1016/j.fawpar.2022.e00184 -
Respiratory Medicine Case Reports 2020Paragonimiasis, or Oriental lung fluke is a parasitic infestation seen in Asia, Africa and South America which is spread by the consumption of crabs and crayfish. To...
Paragonimiasis, or Oriental lung fluke is a parasitic infestation seen in Asia, Africa and South America which is spread by the consumption of crabs and crayfish. To date four cases have been reported from Nepal. Here, we report a case of paragonimiasis in a young male from Kathmandu valley who presented with symptoms of fever, on and off for 1 month, shortness of breath and cough. He was found to have pleural effusion. Sputum examination did not reveal acid fast bacilli, However, based on clinical features, he was started on antitubercular treatment. There was initial improvement, but later, he continued to have cough and hemoptysis over the next 2 years and on subsequent High-Resolution Computerized Tomography (HRCT) he was found to have a cavitary lung lesion in the superior segment of lower lobe of left lung. A possibility of aspergillosis was considered for which he underwent a lobectomy. The gross examination of the lung showed a small cavity measuring 5 mm which revealed on histology a parasitic structure with serous glands within it. In addition, there were many foreign body granulomas with ova within them. A diagnosis of paragonimiasis was made and the patient was started on Praziquantal. He recovered well and is currently asymptomatic. We can learn from this case that the signs and symptoms of paragonimiasis mimic that of tuberculosis and the mistaken diagnosis can lead to unnecessary treatment, prolonged morbidity and loss of time and resources.
PubMed: 33304807
DOI: 10.1016/j.rmcr.2020.101298 -
Frontiers in Pediatrics 2023The clinical manifestations of paragonimiasis are diverse and non-specific, and can easily lead to misdiagnosis. We aimed to analyze the clinical manifestations,...
INTRODUCTION
The clinical manifestations of paragonimiasis are diverse and non-specific, and can easily lead to misdiagnosis. We aimed to analyze the clinical manifestations, laboratory features, treatment, and clinical outcome of children with paragonimiasis in order to improve recognition of this disease and avoid misdiagnosis.
METHODS
Children diagnosed with paragonimiasis from August 2016 to July 2022 were included in the study. Information on population informatics, medical history, and laboratory features was extracted from case data. The clinical features of paragonimiasis were retrospectively analyzed.
RESULTS
A total of 45 children were included in this study. All children had, at least, one risk factor. The clinical features mainly included fever, cough, pleural effusion, peritoneal effusion, and subcutaneous nodules. The main imaging findings were alveolar exudation, peritoneal effusion, pleural thickening, and local nodules. The "tunnel sign" finding on computed tomography (CT)/magnetic resonance imaging (MRI) was helpful in establishing the diagnosis of paragonimiasis. After praziquantel treatment, most of the children improved, and one child with cerebral paragonimiasis experienced sequelae.
CONCLUSION
Most children with paragonimiasis have a good prognosis, but few children can experience sequelae. Avoidance of untreated water and raw food is a simple, feasible, and effective preventive measure.
PubMed: 37266536
DOI: 10.3389/fped.2023.1143262 -
PLoS Neglected Tropical Diseases Mar 2022Cerebral paragonimiasis (CP), caused by aberrant migration of Paragonimus worms, frequently invokes serious illness. The causal relationship between the lesion...
Cerebral paragonimiasis (CP), caused by aberrant migration of Paragonimus worms, frequently invokes serious illness. The causal relationship between the lesion characteristics and patients' symptoms has poorly been understood. CP serodiagnosis has not been properly evaluated to date. A total of 111 CP cases were diagnosed in our laboratory between 1982 and 2003. This study retrospectively assessed the clinical and imaging characteristics of the 105 patients along with the evaluation of diagnostic potentials of recombinant P. westermani yolk ferritin (rPwYF) by enzyme-linked immunosorbent assay (ELISA) employing patients' sera and cerebrospinal fluids (CSFs). We analyzed 60 male and 45 female patients; 50 early-stage patients with non-calcified enhancing nodule(s) (median age, 38 years; interquartile range [IQR], 24.75-52; median symptom duration, 0.75 years; IQR, 0.2-2) and 54 chronic cases having calcified lesion(s) (median age, 33 years; IQR, 25-41; median symptom duration, 10 years; IQR, 5-20). One patient showed a normal neuroimage. The patients were largely diagnosed in their 30s. The parietal lobe was most commonly affected, followed by occipital, frontal, and temporal lobes. Twenty-six patients had lesions encompassing ≥ two lobes. The patients complained mainly of seizures, headaches, hemiparesis, and focal neurologic deficits (P < 0.001). Seizures and visual defects were predominant in patients with calcified lesion(s) (P < 0.001). The diagnostic sensitivity and specificity of rPwYF against serum/CSF were 100%/97% and 97.2%/92.5%, respectively. The specific IgG antibody levels against rPwYF in sera and CSFs showed a positive correlation (r = 0.59). The clinical manifestations of the early-stage patients might be associated with cortical lesions or meningeal irritation, while those in the chronic stage were caused by conglomerated space-occupying lesions. rPwYF would be useful for the serodiagnosis of both early and chronic CP cases.
Topics: Animals; Antibodies, Helminth; Enzyme-Linked Immunosorbent Assay; Female; Ferritins; Humans; Male; Paragonimiasis; Paragonimus; Retrospective Studies; Seizures; Serologic Tests
PubMed: 35294433
DOI: 10.1371/journal.pntd.0010240