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The Korean Journal of Internal Medicine Jan 2015Pleuropulmonary paragonimiasis produces no specific symptoms or radiologic findings, allowing for the possibility of misdiagnosis. We evaluated the specific clinical and...
BACKGROUND/AIMS
Pleuropulmonary paragonimiasis produces no specific symptoms or radiologic findings, allowing for the possibility of misdiagnosis. We evaluated the specific clinical and pleural fluid features of pleuropulmonary paragonimiasis masquerading as pleural tuberculosis.
METHODS
We retrospectively analyzed the clinical and radiologic characteristics of 20 patients diagnosed with pleuropulmonary paragonimiasis between 2001 and 2011.
RESULTS
In total, 17 patients presented with respiratory symptoms, including dyspnea (30%), hemoptysis (20%), cough (20%), and pleuritic chest pain (15%). Chest radiographs revealed intrapulmonary parenchymal lesions, including air-space consolidation (30%), nodular opacities (20%), cystic lesions (15%), ground-glass opacities (10%), and pneumothorax (5%). A pleural fluid examination revealed eosinophilia, low glucose levels, and high lactate dehydrogenase (LDH) levels in 87%, 76%, and 88% of the patients, respectively. These traits helped to distinguish pleuropulmonary paragonimiasis from other pleural diseases such as parapneumonic effusion, malignancy, and pleural tuberculosis.
CONCLUSIONS
Pleuropulmonary paragonimiasis is often initially misdiagnosed as other pleural diseases. Therefore, it is important to establish the correct diagnosis. In patients with unexplained pleural effusion living in paragonimiasis-endemic areas, pleural fluid obtained by thoracentesis should be examined to distinguish pleuropulmonary paragonimiasis. When marked eosinophilia, high LDH levels, and low glucose levels are identified in pleural fluid, physicians could consider a diagnosis of pleuropulmonary paragonimiasis.
Topics: Adolescent; Adult; Aged; Animals; Biomarkers; Child; Child, Preschool; Diagnosis, Differential; Enzyme-Linked Immunosorbent Assay; Eosinophilia; Female; Glucose; Humans; L-Lactate Dehydrogenase; Lung Diseases, Parasitic; Male; Middle Aged; Paracentesis; Paragonimiasis; Paragonimus westermani; Pleural Effusion; Predictive Value of Tests; Retrospective Studies; Tomography, X-Ray Computed; Tuberculosis, Pleural; Young Adult
PubMed: 25589836
DOI: 10.3904/kjim.2015.30.1.56 -
West African Journal of Medicine 2020Paragonimiasis is endemic in Eastern Nigeria. An upsurge was recorded after the Nigeria/Biafra war as protein lack in Biafra forced people to eat fresh water crabs. Its...
BACKGROUND AND OBJECTIVES
Paragonimiasis is endemic in Eastern Nigeria. An upsurge was recorded after the Nigeria/Biafra war as protein lack in Biafra forced people to eat fresh water crabs. Its protean manifestations create confusion with several diseases. Elimination was assumed after a while and suspicion index fell. The interest in reporting this case follows its presentation outside the traditional endemic zone.
RESULTS
The patient, though living in Eastern Nigeria and manifesting several pointers of Paragonimiasis, was treated as tuberculosis despite negative sputum AFB; without improving. He then presented up-country in Jos where history led to suspicion and confirmation of Paragonimiasis. By this time he had severe cor-pulmonale and died despite treatment.
CONCLUSION
In this current economic downturn in Nigeria which may drive people to cheaper protein sources, a high index of suspicion should be raised for paragonimiasis when a patient presents with chronic cough productive of AFB-negative sputum and haemoptysis.
Topics: Animals; Diagnosis, Differential; Fatal Outcome; Humans; Lung Diseases, Parasitic; Male; Nigeria; Paragonimiasis; Paragonimus; Sputum; Tuberculosis, Pulmonary
PubMed: 32030717
DOI: No ID Found -
The Brazilian Journal of Infectious... Feb 2007The authors present a case from a 59 years old white female Brazilian patient, based in Salvador-Bahia, Brazil's northeastern side area, who experienced irritative cough...
The authors present a case from a 59 years old white female Brazilian patient, based in Salvador-Bahia, Brazil's northeastern side area, who experienced irritative cough and progressive dyspnea, and, after 18 months, was admitted to a hospital with respiratory insufficiency. The physical exam showed diffuse rales in both hemithoraces. Initial leukogram showed 14,400 cells/microL with 14% of eosinophils and chest X-ray showed peribronchovascular infiltrate, predominating in the lower half of the lung fields, and small opaque nodules. The high-resolution computed tomography scan of the chest (HRCT) presented compatible pattern with airways disease, especially from the small airways, with air trapping, tree sprouting images, central lobular nodules and bronchiectasis, making the results compatible with bronchiolitis and bronchiectasis. The transbroncho biopsy unveiled granulomatous lesion with necrosis, where was noticed a structure compatible to a parasitic case, and the research of the parasite eggs in the sputum was positive to paragonimus. After the praziquantel use, the patient presented a thick ferruginous expectoration and the result for BAAR examination was positive. The PCR exam and the sputum culture confirmed M. tuberculosis, and then the treatment for M. tuberculosis was initiated. The authors warn that this infection may have been a consequence of economics globalization process, where the importation of parasitized crustaceans might be the cause. However, there is the need of an accurate examination for the possibility of paragonimus specimens in this area of Brazil.
Topics: Animals; Anthelmintics; Brazil; Female; Humans; Lung Diseases, Parasitic; Middle Aged; Paragonimiasis; Paragonimus; Praziquantel
PubMed: 17625745
DOI: 10.1590/s1413-86702007000100031 -
The Indian Journal of Chest Diseases &... 2004A 27-year-old married male from Lamdeng village of Imphal West District, Manipur presented with cough, fever, haemoptysis, anorexia and weight loss, and was treated with...
A 27-year-old married male from Lamdeng village of Imphal West District, Manipur presented with cough, fever, haemoptysis, anorexia and weight loss, and was treated with antituberculosis drugs continuously for one year without improvement. He also had history of ingestion of raw crabs. Chest radiograph revealed right midzone lesion with cavitation. Laboratory investigations revealed peripheral blood eosinophilia, elevated erythrocyte sedimentation rate and sputum smear revealed eggs of Paragonimus westermani. He responeded well to treatment with praziquantel 25 mg/kg, three times a day for three days and is doing well on follow-up. Pulmonary paragonimiasis must be considered in the differential diagnosis of slowly resolving pneumonias, especially in the appropriate clinical setting because effective treatment with praziquantel can be rewarding.
Topics: Adult; Anthelmintics; Diagnosis, Differential; Humans; Lung Diseases, Parasitic; Male; Paragonimiasis; Paragonimus westermani; Praziquantel; Tuberculosis, Pulmonary
PubMed: 15553214
DOI: No ID Found -
The Journal of Veterinary Medical... May 2023A 6-year-old castrated male Cavalier King Charles Spaniel was referred to the Animal Medical Center, Tokyo University of Agriculture and Technology, for examination and...
A 6-year-old castrated male Cavalier King Charles Spaniel was referred to the Animal Medical Center, Tokyo University of Agriculture and Technology, for examination and treatment of recurrent pneumothorax. Chest radiography and computed tomography showed multiple cavitary lesions in the caudal right posterior lobe. These lesions were surgically excised via thoracotomy. Subsequent histopathological examination revealed paragonimiasis. In the postoperative review, we found that the owner had fed raw deer meat to the dog four months earlier. Deer meat has attracted attention as a source of Paragonimus in humans. To our knowledge, this is the first report of Paragonimus infection in a dog due to deer meat consumption.
Topics: Animals; Dogs; Humans; Male; Deer; Dog Diseases; Meat; Paragonimiasis; Paragonimus; Tomography, X-Ray Computed
PubMed: 36948633
DOI: 10.1292/jvms.22-0443 -
Neurologia Medico-chirurgica Mar 1992Five cases of cerebral paragonimiasis presenting with hemianopsia, convulsion, and gait disturbance are discussed. The cases were all in the chronic stage. The...
Five cases of cerebral paragonimiasis presenting with hemianopsia, convulsion, and gait disturbance are discussed. The cases were all in the chronic stage. The intradermal paragonimiasis reaction, complement fixation, and Ouchterlony tests were not useful for diagnosis. Computed tomography demonstrated calcifications in all cases in sites consistent with the foci of symptoms. Surgical treatment in two cases failed to improve symptoms.
Topics: Adult; Aged; Animals; Brain; Brain Diseases; Calcinosis; Complement Fixation Tests; Diagnosis, Differential; Female; Humans; Immunodiffusion; Male; Neurologic Examination; Paragonimiasis; Paragonimus; Tomography, X-Ray Computed
PubMed: 1377799
DOI: 10.2176/nmc.32.157 -
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 -
Pediatric Neurology Mar 2015Paragonimiasis is a parasitic disease that typically produces a subacute to chronic inflammatory disease of the lung. Although rare in the United States, paragonimiasis...
BACKGROUND
Paragonimiasis is a parasitic disease that typically produces a subacute to chronic inflammatory disease of the lung. Although rare in the United States, paragonimiasis is sporadically observed in the immigrant population. Rarely, paragonimiasis can affect the nervous system. This infection is even more unusual in the pediatric population, and therefore can be challenging to diagnose.
PATIENTS
Here we present a child with cerebral paragonimiasis. She presented with new onset seizures in the setting of a febrile illness. Magnetic resonance imaging of the brain with contrast revealed a ring-enhancing lesion within the right frontal lobe and a second lesion in the left parietal lobe extending from the cortex to the centrum semiovale. Extensive evaluation including stool ova and parasite analysis confirmed the diagnosis of Paragonimus westermani. She was treated with praziquantel and prednisone and improved both clinically and radiographically.
CONCLUSIONS
Cerebral paragonimiasis is diagnosable and treatable and therefore is important to consider in the differential of immigrants presenting with cavitary lung lesions and central nervous system findings.
Topics: Central Nervous System Parasitic Infections; Cerebral Cortex; Child; Female; Humans; Magnetic Resonance Imaging; Paragonimiasis; Tomography, X-Ray Computed
PubMed: 25556153
DOI: 10.1016/j.pediatrneurol.2014.11.001 -
Clinical Nuclear Medicine Sep 2010A 72-year-old asymptomatic man with a hepatic lesion incidentally detected by ultrasonography in routine examination undertook fluorodeoxyglucose (FDG)-positron emission...
A 72-year-old asymptomatic man with a hepatic lesion incidentally detected by ultrasonography in routine examination undertook fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography for further evaluation. The images revealed increased FDG activity in the lesion, which was suggestive of malignancy. However, the pathologic examination demonstrated that the lesion was a granuloma caused by Paragonimus westermani, a lung fluke. Although increased FDG activity in the lung due to P. westermani infection is expected and reported previously, such lesion identified in the liver by FDG positron emission tomography/computed tomography is unusual.
Topics: Aged; Animals; Fluorodeoxyglucose F18; Humans; Liver Neoplasms; Male; Paragonimiasis; Paragonimus westermani; Positron-Emission Tomography; Tomography, X-Ray Computed
PubMed: 20706055
DOI: 10.1097/RLU.0b013e3181ea33e5 -
The International Journal of... May 2011To determine how pulmonary paragonimiasis may be confused with lung cancer, we retrospectively analysed the clinical and radiological characteristics of 47 patients (27...
OBJECTIVE AND DESIGN
To determine how pulmonary paragonimiasis may be confused with lung cancer, we retrospectively analysed the clinical and radiological characteristics of 47 patients (27 males, median age 55 years; interquartile range 49-61) with serologically or histopathologically confirmed pulmonary paragonimiasis seen between October 2004 and December 2009.
RESULTS
Respiratory symptoms were present in 29 (62%) patients; the remaining 18 (38%) were asymptomatic. Chest radiography (CXR) revealed intrapulmonary parenchymal lesions (n = 35, 75%) more frequently than pleural lesions (n = 11, 23%). Of the 47 patients, 28 (60%) were referred for suspected lung cancer. The majority of these patients had no symptoms, and 22 (79%) patients with suspected lung cancer had nodular or mass lesions on CXR. As a result, additional diagnostic procedures were performed to make an accurate diagnosis in these patients, including bronchoscopy in 20, transthoracic lung biopsy in 11 and fluorodeoxyglucose positron emission tomography in seven. Surgical lung resection was performed unnecessarily in six patients.
CONCLUSIONS
Pulmonary paragonimiasis presenting with nodular or mass lesions on CXR is common. Clinicians should therefore include pulmonary paragonimiasis in the differential diagnosis of asymptomatic nodular lesions in the lung in patients who have lived in or travelled to paragonimiasis-endemic areas.
Topics: Biopsy; Bronchoscopy; Diagnosis, Differential; Female; Humans; Lung Diseases; Lung Neoplasms; Male; Middle Aged; Paragonimiasis; Positron-Emission Tomography; Radiography; Republic of Korea; Retrospective Studies
PubMed: 21756521
DOI: 10.5588/ijtld.10.0494