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Internal Medicine (Tokyo, Japan) Aug 2020An asymptomatic 47-year-old woman was admitted with pleural effusion and pulmonary infiltrates 1 month after ingesting raw wild boar and deer meat. Both her blood and...
An asymptomatic 47-year-old woman was admitted with pleural effusion and pulmonary infiltrates 1 month after ingesting raw wild boar and deer meat. Both her blood and pleural fluid were eosinophilic. Thoracoscopy revealed multiple nodules of the pleura, and biopsy samples of the nodules showed necrosis with epithelioid cell granulomas. An enzyme-linked immunosorbent assay was positive for antibodies against Paragonimus westermani, and the patient was successfully treated with praziquantel. This is the first reported case of pulmonary or pleuropulmonary paragonimiasis where several pleural nodules were observed. The detection of pleural nodules on thoracoscopy can contribute to the prompt and accurate diagnosis of paragonimiasis.
Topics: Animals; Deer; Enzyme-Linked Immunosorbent Assay; Female; Humans; Meat; Middle Aged; Paragonimiasis; Paragonimus westermani; Pleura; Pleural Effusion; Praziquantel; Respiratory Tract Infections; Sus scrofa; Thoracoscopy
PubMed: 32350198
DOI: 10.2169/internalmedicine.4457-20 -
Acta Tropica Mar 2020Paragonimiasis, an important food-borne zoonosis, is caused by lung flukes of the genus Paragonimus. Several million people are actually infected or at risk....
Paragonimiasis, an important food-borne zoonosis, is caused by lung flukes of the genus Paragonimus. Several million people are actually infected or at risk. Paragonimiasis is a re-emerging disease in developing countries. Diagnosis of pulmonary paragonimiasis is made by finding eggs in sputa and/or fecal samples. Eggs are typically not found in ectopic paragonimiasis cases, so diagnosis depends on supportive information, such as a history of eating fresh water crabs or crayfishes, radiographic findings and immunological tests. Here, a new point-of-care-testing (POCT) tool is presented. It uses immunochromatography for serodiagnosis of human paragonimiasis using excretory-secretory antigen from Paragonimus heterotremus. It proved effective in diagnosing infections due to P. heterotremus, and was also successfully diagnosed with sera from infections with P. westermani and P. miyazakii. The diagnostic sensitivity, specificity, positive and negative predictive values and accuracy were 97.9%, 87.6%, 78%, 98.9%, and 90.8%, respectively. The developed POCT tool is rapid and simple to use not only for clinical diagnosis of paragonimiasis at the bedside or at well-equipped laboratories, but also at local and remote hospitals with limited facilities. Moreover, the POCT tool could be applied for epidemiological surveys of paragonimaisis in Asia where P. heterotremus, P. westermani and P. miyazakii are endemic.
Topics: Animals; Chromatography, Affinity; Gerbillinae; Humans; Male; Paragonimiasis; Point-of-Care Testing; Serologic Tests
PubMed: 31891708
DOI: 10.1016/j.actatropica.2019.105325 -
Journal of Infection and Chemotherapy :... Jul 2024Paragonimiasis is a parasitic disease primarily contracted through consumption of undercooked freshwater crustaceans or wild boar meat. Large-scale nationwide...
BACKGROUND
Paragonimiasis is a parasitic disease primarily contracted through consumption of undercooked freshwater crustaceans or wild boar meat. Large-scale nationwide epidemiological data on paragonimiasis are lacking. In this study, we aimed to investigate the nationwide epidemiology of hospitalized patients with paragonimiasis in Japan using a comprehensive nationwide Japanese administrative database.
METHODS
We evaluated the Japanese Diagnosis Procedure Combination (DPC) data of patients diagnosed with pulmonary paragonimiasis between April 1, 2012 and March 30, 2020. The patients' address and information, including age, sex, treatment (medication: praziquantel; surgery: open thoracotomy or intracranial mass extirpation), Japan coma scale, comorbidities, and length of hospital stay, were extracted.
RESULTS
Of the 49.6 million hospitalized patients, data were extracted on 73 patients with paragonimiasis, of whom 36 were male and 37 were female. The mean age was 49.7 years and the mean length of stay was 12.5 days. The most frequent comorbidity was pleural effusion (31.5 %), followed by pneumothorax (13.7 %). The sites of ectopic paragonimiasis in organs other than the lung included the liver (5.5 %), skin (4.1 %), and brain (2.7 %). Geographically, most patients were from the Kyushu region (54.8 %), followed by the Kanto region (22.0 %). Fukuoka Prefecture had the highest number of patients (22.0 %) by prefecture. During the study period, an average of 9.1 patients/year were hospitalized with lung paragonimiasis in Japan.
CONCLUSION
Paragonimiasis has not completely disappeared in Japan; thus, physicians should be aware of paragonimiasis in the Kyushu region, especially in the Fukuoka Prefecture.
Topics: Humans; Paragonimiasis; Japan; Male; Female; Middle Aged; Adult; Databases, Factual; Aged; Length of Stay; Lung Diseases, Parasitic; Young Adult; Hospitalization; Praziquantel; Adolescent; Animals; Comorbidity; East Asian People
PubMed: 38219980
DOI: 10.1016/j.jiac.2024.01.005 -
Zhongguo Xue Xi Chong Bing Fang Zhi Za... Apr 2023To explore the improvements of high-fat intake on lung injury induced by infection in rats, and to preliminarily explore the mechanisms underlying the role of...
OBJECTIVE
To explore the improvements of high-fat intake on lung injury induced by infection in rats, and to preliminarily explore the mechanisms underlying the role of cytochrome P450 4A1 (CYP 4A1) in the improve ments.
METHODS
SD rats were randomly assigned into three groups, including the normal control group ( = 10), the infection and normal diet group ( = 12) and the infection and high-fat diet group ( = 12). Rats in the normal control group were fed with normal diet and without any other treatments, and animals in the infection and normal diet group were subcutaneously injected with 8 excysted metacercariae of via the abdominal wall, followed by feeding with normal diet, while rats in the infection and high-fat diet group were subcutaneously injected with 8 excysted metacercariae of via the abdominal wall, followed by feeding with high-fat diet. All rats were sacrificed 28 weeks post-infection, and serum samples and lung specimens were collected. Following hematoxylin-eosin (HE) staining of rat lung specimens, the rat lung injury was observed under an optical microscope, and alveolitis was evaluated using semi-quantitative scoring. Serum interleukin-1β (IL-1β) and tumor necrosis factor alpha (TNF-α) levels were measured using enzyme-linked immunosorbent assay (ELISA), and the cytochrome P450 4A1 (CYP 4A1) expression was quantified in rat lung specimens at transcriptional and translational levels using quantitative real-time PCR (qPCR) and Western blotting assays.
RESULTS
Alveolar wall thickening, edema and inflammatory cell infiltration were alleviated 28 weeks post-infection with in rats in the infection and high-fat diet group relative to the infection and normal diet group, and no alveolar consolidation was seen in the infection and high-fat diet group. The semi-quantitative score of alveolitis was significantly higher in the infection and normal diet group [(2.200 ± 0.289) points] than in the normal control group [(0.300 ± 0.083) points] and the infection and high-fat diet group [(1.300 ± 0.475) points] (both values < 0.05), and higher serum IL-1β [(151.586 ± 20.492)] pg/mL and TNF-α levels [(180.207 ± 23.379) pg/mL] were detected in the infection and normal diet group than in the normal control group [IL-1β: (103.226 ± 3.366) pg/mL; TNF-α: (144.807 ± 1.348) pg/mL] and the infection and high-fat diet group [IL-1β: (110.131 ± 12.946) pg/mL; TNF-α: (131.764 ± 27.831) pg/mL] (all values < 0.05). In addition, lower (3.00 ± 0.81) and protein expression (0.40 ± 0.02) was quantified in lung specimens in the infection and normal diet group than in the normal control group [(5.03 ± 2.05) and (0.84 ± 0.14)] and the infection and high-fat diet group [(11.19 ± 3.51) and (0.68 ± 0.18)] (all values < 0.05).
CONCLUSIONS
High-fat intake may alleviate lung injuries caused by infection in rats through up-regulating CYP 4A1 expression in lung tissues at both translational and transcriptional levels.
Topics: Rats; Animals; Lung Injury; Tumor Necrosis Factor-alpha; Rats, Sprague-Dawley; Lung; Paragonimiasis; Paragonimus
PubMed: 37253566
DOI: 10.16250/j.32.1374.2022243 -
International Journal of Infectious... Oct 2023Pleural effusion caused by lung fluke is a rare etiology of exudative pleural effusion (EPE), which is often misdiagnosed or delayed. We aim to summarize the diagnosis...
OBJECTIVES
Pleural effusion caused by lung fluke is a rare etiology of exudative pleural effusion (EPE), which is often misdiagnosed or delayed. We aim to summarize the diagnosis and treatment course of EPE caused by lung fluke infection and put forward a practical diagnosis approach.
METHODS
We retrospectively analyzed the diagnosis and treatment of 14 cases of EPE caused by lung fluke infection diagnosed by enzyme-linked immunosorbent assay of serum antibodies or egg detection.
RESULTS
All patients (100%) with an absolute count of eosinophils in peripheral blood exceeded 0.5 × 10/l, and 10 patients (71.4%) had a history of special ingestion. Eosinophilic PE occurred in 11 patients (78.6%), pleural biopsy of medical thoracoscopic demonstrated eosinophils infiltration in nine patients (64.3%), and parasite eggs in one patient. All patients showed positive intradermal tests for Paragonimus-specific antigens and enzyme-linked immunosorbent assay of serum antibodies to Paragonimus.
CONCLUSION
For patients with unexplained PE, lung fluke infection should be highly suspected when pleural fluid or pleural biopsy shows eosinophilic PE or eosinophils infiltration, especially for patients with certain diet history.
Topics: Animals; Humans; Retrospective Studies; Pleural Effusion; Paragonimiasis; Eosinophilia; Paragonimus; Antibodies; Lung
PubMed: 37507085
DOI: 10.1016/j.ijid.2023.07.013 -
Journal of Comparative Pathology Oct 2021Following isolation of pseudorabies virus (PRV) from two hunting dogs in Oita prefecture, Japan, we investigated the PRV antigen distribution in the tissues of the...
Following isolation of pseudorabies virus (PRV) from two hunting dogs in Oita prefecture, Japan, we investigated the PRV antigen distribution in the tissues of the infected animals. At necropsy, PRV-associated lesions included facial oedema, tonsillar and meningeal congestion, blotchy haemorrhages on the pericardium and mitral valves, and incomplete splenic contraction in one dog, with less prominent findings in the other dog. Multiple pulmonary nodules were seen in both cases, caused by the diploid form of Paragonimus westermani lung flukes, as confirmed by PCR-restriction fragment length polymorphism and gene sequencing analyses. Histological examination revealed that the PRV infection was associated with lesions of non-suppurative encephalitis in the brainstem. PRV antigen was detected in the cerebrum, cerebellum, brainstem, submucosal and myenteric plexuses, and mononuclear cells, mainly in the bone marrow, lymph nodes, tonsils and spleen tissues. There was evidence of PRV dissemination to the brain via the trigeminal or olfactory routes, in addition to possible spread to lymphoid organs via infected mononuclear cells.
Topics: Animals; Antigens, Viral; Coinfection; Dog Diseases; Dogs; Herpesvirus 1, Suid; Japan; Paragonimiasis; Paragonimus westermani; Pseudorabies; Working Dogs
PubMed: 34686277
DOI: 10.1016/j.jcpa.2021.08.004 -
Acta Tropica Feb 2020In July of 2012, mass infections with Paragonimus species were detected in the Henan province sickening 11 of 51 people. In May 2011, these individuals had participated...
In July of 2012, mass infections with Paragonimus species were detected in the Henan province sickening 11 of 51 people. In May 2011, these individuals had participated in an excursion during which freshwater crabs were caught and served after being toasted. Before the group infections with Paraginimus species was confirmed, 5 of the 11 patients had been misdiagnosed as tuberculosis (TB) and treated with an anti-TB drug regimen for six months. The most common and typical manifestations were eosinophilia (11/11, 100%) and pulmonary manifestations including, among others, stethalgia and cough (7/11 63.6%). Sero-examination revealed that all 11 patients were seropositive for Paragonimus species. Surprisingly, in our case, one patient presented with hemoptysis and eggs in respiratory secretions, and this is the first time P. skrjabini eggs are detected in the sputum of a patient from the Henan province. Paragonimus metacercariae were collected from 6 of 11 (54.5%) crabs caught at the infection site and were identified as Paraginiumus skrjabini by morphological and molecular examinations. Epidemiological and laboratory evidence confirmed that this is a case of group infection with P. skrjabini. As one of the most neglected tropical diseases (NTD), paragonimiasis should be differentiated diagnosed from TB to avoid the delay of treatment. To our knowledge, this is the second report of a case of group infections with Paraginimus species in Henan, Central China. The first case was reported in 1995. As a kind of food-borne parasitic disease, paragonimiasis should be included in the public health education agenda.
Topics: Adolescent; Adult; Animals; Child; China; Female; Humans; Male; Middle Aged; Paragonimiasis
PubMed: 31351073
DOI: 10.1016/j.actatropica.2019.105111 -
Internal Medicine (Tokyo, Japan) May 2024
Topics: Humans; Paragonimiasis; Omentum; Male; Animals
PubMed: 37813612
DOI: 10.2169/internalmedicine.2543-23 -
Zhongguo Xue Xi Chong Bing Fang Zhi Za... Dec 2021To investigate the populations of freshwater crabs, the intermediate host of and infections in freshwater crabs in the Minjiang River basin along the middle section of...
OBJECTIVE
To investigate the populations of freshwater crabs, the intermediate host of and infections in freshwater crabs in the Minjiang River basin along the middle section of Wuyi Mountain, so as to provide baseline data for parasitic disease control and research and expansion of the parasite resource bank.
METHODS
From November 2020 to April 2021, freshwater crabs were sampled from streams and ditches neighboring residential areas in Jianning County and its neighboring Ninghua, Shaowu, Jiangle and Shunchang counties. The crab species was identified based on the morphological features of the terminal segment of the first abdominal appendage of male crabs, and infections were detected in freshwater crabs. The metacercariae were isolated, and the types of metacercariae were identified based on the metacercaria size, cystic wall thickness, and the excretory bladder and intestinal tract morphology. In addition, the prevalence, intensity and index of metacercaria infections were calculated in freshwater crabs.
RESULTS
There were seven crab species found in Jianning County and six neighboring water systems along the Minjiang River basin, including , , , , , , , and there were metacercariae of three species detected in these crabs, including , and , with a prevalence rate of 43.6% (125/287). The infection rates of , and were 57.1% (48/84), 26.2% (22/84) and 61.8% (21/34) in , and the infection rates of and were 52.6% (51/97) and 30.9% (30/97) in , while the rate of infection was 6.9% (5/72) in , which is the first record of infections in . Mixed and infections were predominantly found in freshwater crabs sampled from Jianning County, where the rate of infections was 70.4% (76/108), with 15.3 metacercariae identified in each crab with infections and 1.9 metacercariae found in each gram of crabs with infections, and the index of metacercariae infections was 20.5. In addition, , and metacercariae were found in freshwater crabs sampled from Jianning-neighboring counties, where the rate of infections was 52.3% (56/107), with 9.8 metacercariae identified in each crab with infections and 0.9 metacercariae found in each gram of crabs with infections, and the index of metacercariae infections was 4.6.
CONCLUSIONS
There are multiple freshwater crab species and infection is high in freshwater crabs in Jianning County and its neighboring Minjiang River basin, which is a high-risk natural focus for infections.
Topics: Animals; Brachyura; Fresh Water; Male; Paragonimiasis; Paragonimus; Rivers
PubMed: 35128889
DOI: 10.16250/j.32.1374.2021154 -
Zhongguo Xue Xi Chong Bing Fang Zhi Za... Dec 2023To investigate the sequences of internal transcribed spacer 2 () and cyclooxygenase 1 () genes of in freshwater crabs in Henan Province, identify the species of and...
OBJECTIVE
To investigate the sequences of internal transcribed spacer 2 () and cyclooxygenase 1 () genes of in freshwater crabs in Henan Province, identify the species of and evaluate its genetic relationships with isolates from other provinces in China.
METHODS
Freshwater crabs were collected from 8 survey sites in Zhengzhou, Luoyang, Pingdingshan, Nanyang and Jiyuan cities of Henan Province from 2016 to 2021, and metacercariae were detected in freshwater crabs. Genomic DNA was extracted from metacercariae, and the and genes were amplified using PCR assay, followed by sequencing of PCR amplification products. The gene sequences were spliced and aligned using the software DNASTAR, and aligned with the sequences of genes in the GenBank. Phylogenetic trees were created using the MEGA6 software with the Neighbor-Joining method based on and gene sequences, with as the outgroup.
RESULTS
The detection rates of were 6.83% (11/161), 50.82% (31/61), 18.52% (5/26), 8.76% (12/137), 14.29% (9/63), 17.76% (19/105), 18.50% (32/173) and 42.71% (41/96) in freshwater crabs from 8 survey sites in Zhengzhou, Luoyang, Pingdingshan, Nanyang and Jiyuan cities of Henan Province, with a mean detection rate of 19.46% (160/822), and a mean infection intensity of 0.57 metacercariae/g. The amplified and gene fragments of were approximately 500 bp and 450 bp in lengths, respectively. The gene sequences of metacercariae from 8 survey sites of Henan Province showed the highest homology (99.8% to 100.0%) with the gene sequence of (GenBank accession number: MW960209.1), and phylogenetic analysis showed that the in this study was clustered into the same clade with from Sichuan Province (GenBank accession number: AY618747.1), Guangxi Zhuang Autonomous Region (GenBank accession number: AY618729.1) and Hubei Province (GenBank accession number: AY618751.1), and from Fujian Province (GenBank accession number: AY618741.1) and Japan (GenBank accession number: AB713405.1). The gene sequences of metacercariae from 8 survey sites of Henan Province showed the highest homology (90.0% to 100.0%) with the gene sequence of (GenBank accession number: AY618798.1), and phylogenetic analysis showed that the in this study was clustered into the same clade with all and clustered into the same sub-clade with from Hubei Province (GenBank accession numbers: AY618782.1 and AY618764.1).
CONCLUSIONS
species from freshwater crabs in Henan Province were all characterized as , and the and gene sequences had the highest homology to those of from Hubei Province. The results provide insights into study of in Henan Province and China.
Topics: Animals; Paragonimus; Brachyura; Cyclooxygenase 1; Phylogeny; China; Sequence Analysis, DNA; Paragonimiasis
PubMed: 38148540
DOI: 10.16250/j.32.1374.2023096