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Iranian Journal of Parasitology 2022Paragonimiasis presents with nonspecific symptoms and radiologic findings, allowing for the possibility of misdiagnosis. Diagnosis is generally delayed due to lack of...
BACKGROUND
Paragonimiasis presents with nonspecific symptoms and radiologic findings, allowing for the possibility of misdiagnosis. Diagnosis is generally delayed due to lack of suspicion and presentation similar to pulmonary tuberculosis.
METHODS
A prospective observational study was carried out on 20 subjects at Civil Service Hospital of Nepal from March 2015 to June 2019 who presented with eosinophilia and pulmonary symptoms, and were treated empirically with Anti-tubercular therapy for suspicion of pulmonary tuberculosis.
RESULTS
The median age of the patient was 34 years. Mean blood absolute eosinophil count was 16678/ul. Fever was present in 80% (n=16). Cough was present in 90% (n=18). Pleural effusion was noticed in 100% (n=20). Chest computed tomography showed ground-glass opacities in 65% (n=13) of patients. Pleural fluid eosinophilia (>10%) was evident in all patients. Pleural fluid LDH was elevated in 85% (n=17) of patients. Similarly, ADA was high (>40U) in 75% (n= 15) of patients, and pleural fluid sugar was low in 80% (n=16) of patients. All patients (100%) gave a history of crab or snail consumption. egg was detected in five (25%) patients. Twenty patients fulfilled definite or probable diagnostic criteria of paragonimiasis. Ninety-five (n=19) patients responded to praziquantel.
CONCLUSION
Unavailability of serologic tests or failure to demonstrate parasitic egg under the microscope should not discourage physicians to consider the diagnosis of paragonimiasis when marked eosinophilia, high LDH levels, and low glucose levels are identified in pleural fluid of a patient with a history of raw crab or snail consumption.
PubMed: 36466025
DOI: 10.18502/ijpa.v17i3.10632 -
International Journal of Infectious... Aug 2023
Topics: Animals; Humans; Paragonimus westermani; Mediastinal Cyst; Paragonimiasis
PubMed: 37150353
DOI: 10.1016/j.ijid.2023.05.001 -
Internal Medicine (Tokyo, Japan) Feb 2024
PubMed: 38311422
DOI: 10.2169/internalmedicine.3179-23 -
Pathogens and Global Health May 2020Improving paragonimiasis surveillance, which is crucial for disease control, requires adopting new tools and techniques useful in mapping endemic areas. This study aimed...
Identification of suspected paragonimiasis-endemic foci using a questionnaire and detection of ova using the Ziehl-Neelsen technique in Zamboanga Region, the Philippines.
Improving paragonimiasis surveillance, which is crucial for disease control, requires adopting new tools and techniques useful in mapping endemic areas. This study aimed to (1) develop a questionnaire to identify suspected paragonimiasis-endemic foci, (2) describe the epidemiology of paragonimiasis, and (3) evaluate Ziehl-Nielsen Staining technique (ZNS) in detecting ova. The questionnaire, which municipal health officers filled out, was based on proposed site inclusion criteria utilized in the integrated tuberculosis (TB)-paragonimiasis surveillance and control project. Newly deployed medical technologists in Zamboanga Region underwent training, which included laboratory diagnosis of paragonimiasis using preserved and fresh specimens and an integrated tuberculosis-paragonimiasis survey in nine selected (villages). Paragonimiasis cases were found in seven out of the nine barangays identified by the questionnaire. Of the 373 patients, three (0.80%) were TB-positive, and 29 (7.77%) were paragonimiasis-positive. The highest paragonimiasis prevalence (27%) was found in Barangay Libato. Ziehl-Neelsen Staining technique (ZNS) correctly detected 8 out of the 29 samples positive (sensitivity - 27.59%; 95% CI: 12.73-47.24%) and all the 334 samples negative (specificity - 100%; 95% CI: 98.90-100%) for ova. The questionnaire may be improved by refining the inclusion criteria. In paragonimiasis-endemic areas, the ZNS and the NaOH concentration technique may be used for detecting ova. Modifying the ZNS, for instance by including a concentration step, may improve its sensitivity. The model for the integrated capacity building of health workers and surveillance and research demonstrated in this project may contribute to improving surveillance and control of paragonimiasis and other neglected tropical diseases.
Topics: Adolescent; Adult; Animals; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Middle Aged; Paragonimiasis; Paragonimus; Parasite Egg Count; Philippines; Surveys and Questionnaires; Young Adult
PubMed: 32191613
DOI: 10.1080/20477724.2020.1741900 -
Parasitology Sep 2022Human autochthonous infections with the trematode are increasingly being reported in North America, but the true prevalence and geographic distribution are unknown.... (Review)
Review
Human autochthonous infections with the trematode are increasingly being reported in North America, but the true prevalence and geographic distribution are unknown. Ingestion of raw crayfish is reported in most human cases, typically in the context of alcohol intoxication. Risk of infection varies depending on what part of the crayfish is ingested as metacercariae of (>50% mature to adults) localize to the heart and pericardium of the crayfish. Reported human cases have manifested primarily in otherwise healthy young adults presenting with severe eosinophilic pneumonia, pleuritis, systemic symptoms, dermatologic lesions and cerebral involvement. However, it is likely that many infections go unreported due to lack of awareness, mild illness or the absence of rapid commercially available diagnostic tests. Promising advances have been made related to novel diagnostic targets. Conservation of these antigen targets among at least four species could make these antigens viable for diagnostic testing of specifically as well as other species, but additional studies and funding investments are required. Public and physician awareness may have improved due to targeted education campaigns, but ongoing activities to raise awareness are needed, particularly in areas where cases have not been frequently reported to date.
Topics: Animals; Astacoidea; Humans; Metacercariae; North America; Paragonimiasis; Paragonimus
PubMed: 35965058
DOI: 10.1017/S0031182021001359 -
Respirology Case Reports May 2021Human paragonimiasis has been appearing all over the world due to increased human migration, international travel, and worldwide food trading. However, delayed and...
Human paragonimiasis has been appearing all over the world due to increased human migration, international travel, and worldwide food trading. However, delayed and missed diagnosis rates are also increasing due to atypical clinical manifestations and the lack of disease understanding by clinical workers. We describe the case of a 43-year-old man, who was hospitalized with cough and chest pain for two months. Chest computed tomography (CT) revealed bilateral emphysema, left pleural effusion, and bilateral atelectasis. The hypereosinophilia gave us a clue; ultimately, the diagnosis of paragonimiasis was made through a diet history and a positive result of serum sp. immunoglobulin (Ig) G antibody. Moreover, 27 misdiagnosed paragonimiasis cases in the past decade have been reported. We draw conclusions by summarizing their characteristics for suspicious eosinophilic paragonimiasis patients; we should inquire diet history carefully, test serum IgG antibodies, and try to detect eggs. Once diagnosed, praziquantel is preferred for treatment.
PubMed: 33959297
DOI: 10.1002/rcr2.750 -
Frontiers in Neurology 2022To investigate the computed tomography (CT) and magnetic resonance image (MRI) manifestations of cerebral paragonimiasis (CP) in children and to improve the...
OBJECTIVE
To investigate the computed tomography (CT) and magnetic resonance image (MRI) manifestations of cerebral paragonimiasis (CP) in children and to improve the understanding of the disease.
METHODS
The cranial CT and MRI data of 12 children with positive intradermal tests for -specific antigens were retrospectively analyzed. Additionally, the lesion locations, morphology, and imaging characteristics were analyzed.
RESULTS
The lesions were located in the cerebral parenchyma in 12 cases, with 10 in the supratentorial area and two in the subtentorial area, among which three cases included involvement of the meninges. The morphology of the lesions was mainly nodular and striated, with clear or indistinct borders and varying degrees of surrounding edema. The lesions showed isodense or slightly hyperdense opacities on the CT scans, heterogeneous equal or slightly decreased signal intensities on the T1-weighted images (TWI), heterogeneous equal or slightly increased signal intensities on the T2-weighted images (TWI), and equal or slightly increased signal intensities on the diffusion-weighted images (DWI) in MRIs. In four cases, the cyst wall showed equal T1 and short T2 signals, and in six cases, the characteristic "tunnel sign" and "worm-eaten sign" were visible. The contrast-enhanced MRI showed strip-shaped enhancement in five cases, nodular or ring-shaped enhancement in three cases, linear enhancement in two cases, and uneven enhancement in two cases. The meninges adjacent to the lesions were thickened with significant enhancement in four cases.
CONCLUSION
CP was mostly located in the cerebral parenchyma with involvement of the adjacent meninges. CT and MRI scans had certain imaging characteristics, and the MRI may particularly be of great value for the diagnosis of CP.
PubMed: 35720062
DOI: 10.3389/fneur.2022.852334 -
Emerging Infectious Diseases Oct 2022Paragonimiasis is a food-borne infection caused by several species of the Paragonimus fluke. Clinical manifestations can mimic tuberculosis and contribute to diagnostic...
Paragonimiasis is a food-borne infection caused by several species of the Paragonimus fluke. Clinical manifestations can mimic tuberculosis and contribute to diagnostic delay. We report a cluster of paragonimiasis in a community in Ecuador, where active surveillance was set up after detection of the first 2 cases.
Topics: Animals; Delayed Diagnosis; Ecuador; Humans; Paragonimiasis; Paragonimus
PubMed: 36148987
DOI: 10.3201/eid2810.220927 -
The Korean Journal of Parasitology Jun 2021Human gnathostomiasis is a parasitic disease caused by Gnathostoma nematode infection. A rapid, reliable, and practical immunoassay, named dot immuno-gold filtration...
Human gnathostomiasis is a parasitic disease caused by Gnathostoma nematode infection. A rapid, reliable, and practical immunoassay, named dot immuno-gold filtration assay (DIGFA), was developed to supporting clinical diagnosis of gnathostomiasis. The practical tool detected anti-Gnathostoma-specific IgG4 in human serum using crude extract of third-stage larvae as antigen. The result of the test was shown by anti-human IgG4 monoclonal antibody conjugated colloidal gold. The sensitivity and specificity of the test were both 100% for detection in human sera from patients with gnathostomiasis (13/13) and from healthy negative controls (50/50), respectively. Cross-reactivity with heterogonous serum samples from patients with other helminthiases ranged from 0 (trichinosis, paragonimiasis, clonorchiasis, schistosomiasis, and cysticercosis) to 25.0% (sparganosis), with an average of 6.3% (7/112). Moreover, specific IgG4 antibodies diminished at 6 months after treatment. This study showed that DIGFA for the detection of specific IgG4 in human sera could be a promising tool for the diagnosis of gnathostomiasis and useful for evaluating therapeutic effects.
Topics: Animals; Antibodies, Helminth; Gnathostoma; Gnathostomiasis; Humans; Immunoglobulin G; Paragonimiasis
PubMed: 34218597
DOI: 10.3347/kjp.2021.59.3.257 -
Genomics & Informatics Sep 2021Semisulcospira libertina, a species of freshwater snail, is widespread in East Asia. It is important as a food source. Additionally, it is a vector of clonorchiasis,...
Semisulcospira libertina, a species of freshwater snail, is widespread in East Asia. It is important as a food source. Additionally, it is a vector of clonorchiasis, paragonimiasis, metagonimiasis, and other parasites. Although S. libertina has ecological, commercial, and clinical importance, its whole-genome has not been reported yet. Here, we revealed the genome of S. libertina through de novo assembly. We assembled the whole-genome of S. libertina and determined its transcriptome for the first time using Illumina NovaSeq 6000 platform. According to the k-mer analysis, the genome size of S. libertina was estimated to be 3.04 Gb. Using RepeatMasker, a total of 53.68% of repeats were identified in the genome assembly. Genome data of S. libertina reported in this study will be useful for identification and conservation of S. libertina in East Asia.
PubMed: 34638179
DOI: 10.5808/gi.21039