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World Journal of Clinical Cases Jan 2021Paragonimiasis is a parasitic disease that has multiple symptoms, with pulmonary types being common. According to our clinical practices, the pleural effusion of our...
BACKGROUND
Paragonimiasis is a parasitic disease that has multiple symptoms, with pulmonary types being common. According to our clinical practices, the pleural effusion of our patients is full of fibrous contents. Drainage, praziquantel, and triclabendazole are recommended for the treatment, but when fibrous contents are contained in pleural effusion, surgical interventions are necessary. However, no related reports have been noted. Herein, we present a case of pulmonary paragonimiasis treated by thoracoscopy.
CASE SUMMARY
A 12-year-old girl presented to our outpatient clinic complaining of shortness of breath after exercise for several days. Enzyme-linked immunosorbent assay revealed positivity for antibodies against , serological test showed eosinophilia, and moderate left pleural effusion and calcification were detected on computed tomography (CT). She was diagnosed with paragonimiasis, and praziquantel was prescribed. However, radiography showed an egg-sized nodule in the left pleural cavity during follow-up. She was then admitted to our hospital again. The serological results were normal except slight eosinophilia. CT scan displayed a cystic-like node in the lower left pleural cavity. The patient underwent a thoracoscopic mass resection. A mass with a size of 6 cm × 4 cm × 3 cm adhered to the pleura was resected. The pathological examination showed that the mass was composed of non-structured necrotic tissue, indicating a granuloma. The patient remainded asymptomatic and follow-up X-ray showed complete removal of the mass.
CONCLUSION
This case highlights that thoracoscopic intervention is necessary when fibrous contents are present on CT scan or chest roentgenogram to avoid later fibrous lump formation in patients with pulmonary paragonimiasis.
PubMed: 33553406
DOI: 10.12998/wjcc.v9.i3.666 -
BMC Infectious Diseases Jul 2019Pleural parasitic infestation (PPI) is a disease prevalent in certain parts of the world. It is frequently misdiagnosed due to its lack of standardized diagnostic...
BACKGROUND
Pleural parasitic infestation (PPI) is a disease prevalent in certain parts of the world. It is frequently misdiagnosed due to its lack of standardized diagnostic criteria. The purpose of this study was to evaluate the clinical characteristics of PPI patients and develop a practical diagnostic approach for PPI.
METHODS
A retrospective study was conducted by reviewing the medical records of 11 patients with PPI. A practical diagnostic approach was proposed based on the unique laboratory findings.
RESULTS
All patients demonstrated respiratory symptoms, including shortness of breath, cough, fever, chest pain, excessive sputum and hemoptysis. Leukocytosis (> 10,000/μL) and eosinophilia (> 500/μL) of peripheral blood were present in 45.5 and 36.4% patients, respectively. The mean concentrations of pleural effusion lactate dehydrogenase (LDH), adenosine deaminase (ADA), protein and carcinoembryonic antigen (CEA) were 338.2 U/L (range, 61-667 U/L), 11.6 U/L (range, 0.1-28.2 U/L), 43.7 g/dL (range, 21.9-88.1 g/dL), and 1.84 mg/mL (range, 0.28-4.8 mg/mL), respectively. The mean percentage of eosinophils in the pleural effusion was 19.5% (10.5-41%). Blood test was positive for parasite-specific IgG antibody in 9 patients, including 4 for Paragonimus westermani, 3 for Taenia solium, 1 for Clonorchis sinensis and 1 for Echinococcus granulosus. Eggs of Clonorchis sinensis were detected in the stool of two patients. Sparganum was found in the pleural effusion of one patient. Respiratory symptoms and abnormal appearances in pulmonary radiographic examination were disappeared in all patients who received anti-parasitic treatment.
CONCLUSIONS
In patients with unexplained pleural effusion, parasite-specific IgG antibody tests should be performed when pleural fluid testing shows eosinophilic pleural effusion. It is preferable to consider the diagnosis of PPI in clinical practice when serum parasite-specific IgG antibody test is positive.
Topics: Aged; Chest Pain; Cough; Eosinophils; Female; Fever; Hemoptysis; Humans; Immunoglobulin G; Male; Middle Aged; Parasitic Diseases; Pleural Effusion; Retrospective Studies; Sputum
PubMed: 31272486
DOI: 10.1186/s12879-019-4179-9 -
World Journal of Clinical Cases Dec 2019Paragonimiasis is a food-borne parasitic infection caused by lung flukes of the genus . Although the most common site of infection is the pleuropulmonary area, the...
BACKGROUND
Paragonimiasis is a food-borne parasitic infection caused by lung flukes of the genus . Although the most common site of infection is the pleuropulmonary area, the parasite can also reach other parts of the body on its journey from the intestines to the lungs, ending up in locations such as the brain, abdomen, skin, and subcutaneous tissues. Ectopic paragonimiasis is difficult to diagnose due to the rarity of this disease.
CASE SUMMARY
Here, we report a rare case of simultaneous breast and pulmonary paragonimiasis in a woman presenting painless breast mass and lung nodule with a history of eating raw trout. To confirm the diagnosis, serologic testing and tissue confirmation of the breast mass were performed. The patient was treated with surgical resection of the mass and praziquantel medication.
CONCLUSION
Ectopic paragonimiasis is difficult to diagnose due to the rarity of this disease. Thus, thorough history-taking and clinical suspicion of parasitic infection are important.
PubMed: 31911910
DOI: 10.12998/wjcc.v7.i24.4292 -
Pathology International Aug 2023
Topics: Animals; Humans; Paragonimus westermani; Brachyura; Soy Foods; Trematoda; Fresh Water
PubMed: 37493110
DOI: 10.1111/pin.13352 -
Annals of Medicine and Surgery (2012) Sep 2021Paragonimiasis, lung fluke disease caused by infection with species, is a food-borne parasitic zoonosis. The overriding symptoms of infection include chronic cough,...
INTRODUCTION
Paragonimiasis, lung fluke disease caused by infection with species, is a food-borne parasitic zoonosis. The overriding symptoms of infection include chronic cough, shortness of breath, and pleuritic pain. Extrapulmonary paragonimiasis caused by aberrant parasitic migration is known to occur in a variety of sites such as the brain, abdominal wall, and intraperitoneal cavity. Ectopic paragonimiasis is an uncommon disease that presents with a few clinical manifestations, which makes it difficult to diagnose and treat.
CASE PRESENTATION
A 47-year-old man with an unremarkable medical and surgical history presented with a peritoneal lesion that was discovered incidentally on abdominal computed tomography during routine health screening. The patient did not exhibit any associated symptoms such as abdominal pain. The radiologic diagnosis was a gastric duplication cyst and we performed laparoscopic excision of the peritoneal mass. Histopathological examination revealed paragonimiasis, and the result of the skin test for paragonimiasis was positive. The patient was treated with praziquantel.
CLINICAL DISCUSSION
The diagnosis of ectopic peritoneal paragonimiasis remains challenging due to inexperience, misdiagnosis, and its rarity. Clinicians should bear in mind that an intra-abdominal mass may be related to a parasitic infection. The detection of the ova of parasites in sputum and biopsy specimens may be difficult due to an insufficient amount.
CONCLUSION
Clinicians need to thoroughly take the patient's history and clinically suspect parasitic infections. Laparoscopic resection of this rare mass is safe, feasible, and allows for rapid recovery.
PubMed: 34484726
DOI: 10.1016/j.amsu.2021.102754 -
Zhongguo Xue Xi Chong Bing Fang Zhi Za... Oct 2021To establish a nucleic acid assay for detection of based on the recombinase-aided isothermal amplification (RAA) technique, and to preliminarily evaluate its detection...
OBJECTIVE
To establish a nucleic acid assay for detection of based on the recombinase-aided isothermal amplification (RAA) technique, and to preliminarily evaluate its detection efficiency.
METHODS
The metacercariae of , and were isolated from crabs, and genomic DNA was extracted for molecular characterization. The cytochrome coxidase 1 () gene sequence of was selected as the target gene fragment, and the primers and probes were designed, screened and synthesized for RAA assay. The genomic DNA of metacercariae from Jiyuan City and Yiyang County of Luoyang City, Henan Province were used as templates for verification of the fluorescent RAA assay. The fluorescent RAA assay was performed to detect different concentrations of plasmids containing target gene fragment and metacercariae genomic DNA to determine the sensitivity. Fluorescent RAA assay was performed with recombinant plasmids containing gene sequences at different concentrations and genomic DNA as templates to evaluate its sensitivity, and the genomic DNA of , , and was detected with fluorescent RAA assay to evaluate its specificity.
RESULTS
, and metacercariae were isolated from crabs, respectively. Molecular characterization and phylogenetic analysis confirmed their homology with the genes sequences of standard strains in GenBank. A fluorescent RAA assay was successfully established for nucleic acid detection of , and the genomic DNA of metacercariae from Jiyuan City and Yiyang County of Luoyang City, Henan Province was amplified using the fluorescent RAA assay within 5 min, while the negative control was not amplified. If the recombinant plasmid containing gene sequences was used as templates, the fluorescent RAA assay showed the lowest detection limit of 10 copies/μL, and positive amplification was observed within 5 min. If genomic DNA was used as templates, the fluorescent RAA assay showed the lowest detection limit of 10 pg/μL, and all positive amplifications were found within 5 to 10 min. In addition, the fluorescent RAA assay was tested negative for , , and .
CONCLUSIONS
A rapid, sensitive and specific fluorescent RAA assay is successfully established for nucleic acid detection of , which has potential values in rapid field detection and species identification in freshwater crabs in areas endemic for .
Topics: Animals; Nucleic Acid Amplification Techniques; Nucleic Acids; Phylogeny; Recombinases; Sensitivity and Specificity
PubMed: 34791843
DOI: 10.16250/j.32.1374.2021218 -
Parasitology Research Aug 2022Secretory enzymes from Schistosoma japonicum are promising candidate antigens in the diagnosis of schistosomiasis. Our previous studies have proven that thioredoxin...
Serological evaluation of the schistosome's secretory enzyme phytochelatin synthase and phosphoglycerate mutase for the detection of human Schistosoma japonicum infection.
Secretory enzymes from Schistosoma japonicum are promising candidate antigens in the diagnosis of schistosomiasis. Our previous studies have proven that thioredoxin peroxidase-1 (SjTPx-1) is useful for the detection of this parasitic disease in humans, water buffaloes, and dogs. In this study, we evaluated two more secretory enzymes namely phosphoglycerate mutase (SjPGM) and phytochelatin synthase (SjPCS) with SjTPx-1 as the reference antigen. SjPGM was shown to have good diagnostic potentials in animal samples in previous studies, whereas SjPCS was chosen because of its absence in the mammalian hosts. Serum samples including 96 endemic negative controls, 107 schistosomiasis japonica positive samples, and 31 samples positive for other parasitic trematode infections (Clonorchis sinensis, Opisthorchis viverrini, Paragonimus westermani) were tested with the antigens using enzyme-linked immunosorbent assay. Results showed that SjPCS detected more positive samples and had fewer cross-reactions than SjPGM. With 85.05% sensitivity and 93.55% specificity, SjPCS can therefore be used in the detection of human schistosomiasis.
Topics: Aminoacyltransferases; Animals; Antigens, Helminth; Enzyme-Linked Immunosorbent Assay; Humans; Phosphoglycerate Mutase; Schistosoma japonicum; Schistosomiasis japonica; Sensitivity and Specificity
PubMed: 35672537
DOI: 10.1007/s00436-022-07568-7 -
Clinical Nuclear Medicine Aug 2023A 32-year-old man underwent 18 F-FDG PET/CT to evaluate suspicious hepatic metastases, which were revealed by ultrasonography and MRI. The FDG PET/CT images demonstrated...
A 32-year-old man underwent 18 F-FDG PET/CT to evaluate suspicious hepatic metastases, which were revealed by ultrasonography and MRI. The FDG PET/CT images demonstrated only one focus of subtly increased activity in the liver without abnormality elsewhere. The pathological result from hepatic biopsy was consistent with Paragonimus westermani infection.
Topics: Humans; Male; Adult; Paragonimiasis; Liver; Positron Emission Tomography Computed Tomography; Magnetic Resonance Imaging; Ultrasonography
PubMed: 37290448
DOI: 10.1097/RLU.0000000000004736 -
Zhongguo Xue Xi Chong Bing Fang Zhi Za... Aug 2021To develop a rapid test for detection of specific gene fragments based on the recombinase-aided isothermal amplification assay (RAA) and nucleic acid dipstick test.
OBJECTIVE
To develop a rapid test for detection of specific gene fragments based on the recombinase-aided isothermal amplification assay (RAA) and nucleic acid dipstick test.
METHODS
The gene fragment was selected as the target gene fragment, and the primers and fluorescent probe were designed and synthesized. Then, a nucleic acid dipstick test was established. The sensitivity of this dipstick test was evaluated by detecting different copies of recombinant plasmids containing the gene fragment and different concentrations of genomic DNA from adult worms of , and the specificity of the dipstick test was evaluated by detecting the genomic DNA from , , , , and .
RESULTS
The nucleic acid dipstick test based on the gene fragment showed the minimum detectable limit of 10 copies/μL of the recombinant plasmid containing the gene fragment and the minimum detectable limit of 1 pg/μL of genomic DNA, and the dipstick assay tested negative for the genomic DNA from , , , , and .
CONCLUSIONS
A rapid, simple, and visualized assay is established for detection of specific gene fragments based on RAA and nucleic acid dipstick test.
Topics: Animals; Nucleic Acid Amplification Techniques; Nucleic Acids; Recombinases; Schistosoma japonicum; Sensitivity and Specificity
PubMed: 34505438
DOI: 10.16250/j.32.1374.2021016 -
Medicina (Kaunas, Lithuania) Jan 2023Paragonimiasis caused by trematodes belonging to the genus is often accompanied by chronic respiratory symptoms such as cough, the accumulation of sputum, hemoptysis,...
Paragonimiasis caused by trematodes belonging to the genus is often accompanied by chronic respiratory symptoms such as cough, the accumulation of sputum, hemoptysis, and chest pain. Prolonged symptoms, including respiratory symptoms, after coronavirus disease 2019 infection (COVID-19) are collectively called post-COVID-19 conditions. Paragonimiasis and COVID-19 may cause similar respiratory symptoms. We encountered five cases of paragonimiasis in patients in Japan for whom diagnoses were delayed due to the initial characterization of the respiratory symptoms as a post-COVID-19 condition. The patients had consumed homemade drunken freshwater crabs together. One to three weeks after consuming the crabs, four of the five patients were diagnosed with probable COVID-19. The major symptoms reported included cough, dyspnea, and chest pain. The major imaging findings were pleural effusion, pneumothorax, and nodular lesions of the lung. All the patients were diagnosed with paragonimiasis based on a serum antibody test and peripheral blood eosinophilia (560-15,610 cells/μL) and were treated successfully with 75 mg/kg/day praziquantel for 3 days. Before diagnosing a post-COVID-19 condition, it is necessary to consider whether other diseases, including paragonimiasis, may explain the symptoms. Further, chest radiographic or blood tests should be performed in patients with persistent respiratory symptoms after being infected with COVID-19 to avoid overlooking the possibility of infection.
Topics: Humans; Paragonimiasis; Cough; Delayed Diagnosis; COVID-19; Chest Pain; COVID-19 Testing
PubMed: 36676761
DOI: 10.3390/medicina59010137