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Journal of Neurosurgery. Pediatrics Jan 2015The authors retrospectively analyzed the clinical characteristics, existing problems, and treatment experiences in recently diagnosed cerebral paragonimiasis (CP) cases...
OBJECT
The authors retrospectively analyzed the clinical characteristics, existing problems, and treatment experiences in recently diagnosed cerebral paragonimiasis (CP) cases and sought to raise awareness of CP and to supply reference data for early diagnosis and treatment.
METHODS
Twenty-seven patients (22 male and 5 female; median age 20.3 years, range 4-47 years) with CP were diagnosed between September 2008 and September 2013. These diagnoses were confirmed by IgG enzyme-linked immunosorbent assays. Follow-up was performed in 24 cases for a period of 6-56 months.
RESULTS
Cerebral paragonimiasis accounted for 21.6% of paragonimiasis cases (27 of 125). The average duration from onset to praziquantel treatment was 69 days. All patients resided in rural areas. Twenty patients had positive lung results, which included visible lung lesions in 14 cases. The lesions were surgically removed in 8 of these cases. Twenty-four patients had high eosinophil counts (≥ 0.08 × 10(9)/L), and eosinophilic meningitis was noted in 17 cases. The rate of misdiagnosis and missed diagnosis was 30.4%. Most symptoms were markedly improved after treatment, but mild movement disorders combined with impaired memory and personality changes remained in a small number of patients.
CONCLUSIONS
Clinicians should be alert to the possibility of CP in young patients (4-16 years) with the primary symptoms of epilepsy and hemorrhage. Early diagnosis and timely treatment can reduce the need for surgery and further impairments to brain function. Liquid-based cytological examination of CSF and peripheral blood eosinophil counts can aid in differentiating CP from similar lesions.
Topics: Adolescent; Adult; Anthelmintics; Central Nervous System Parasitic Infections; Child; Child, Preschool; China; Diagnosis, Differential; Early Diagnosis; Enzyme-Linked Immunosorbent Assay; Epilepsy; Female; Humans; Lung Diseases, Parasitic; Male; Middle Aged; Paragonimiasis; Photomicrography; Praziquantel; Retrospective Studies; Rural Population; Tomography, X-Ray Computed; Treatment Outcome; Young Adult
PubMed: 25380173
DOI: 10.3171/2014.10.PEDS14208 -
Tropical Biomedicine Mar 2020Paragonimiasis is an infection caused by Paragonimus, a lung fluke and is acquired by eating raw or undercooked crustaceans containing the infective metacercariae....
Paragonimiasis is an infection caused by Paragonimus, a lung fluke and is acquired by eating raw or undercooked crustaceans containing the infective metacercariae. Herein, we report a case of paragonimiasis in a Malaysian man who presented with incidental findings from chest radiographs. Examination of his biopsied lung tissue and sputum specimen revealed Paragonimus sp. eggs, whereas stool examination showed the presence of Giardia cysts. Patient was succesfully treated with praziquantel and metronidazole respectively.
Topics: Animals; Food Contamination; Giardiasis; Humans; Incidental Findings; Lung; Malaysia; Male; Metronidazole; Middle Aged; Paragonimiasis; Paragonimus; Praziquantel; Sputum
PubMed: 33612715
DOI: No ID Found -
Arkhiv Patologii 2018Larval paragonimiasis is a parasitic disease caused by lung fluke larvae. Unlike the classic form of paragonimiasis, the larval form occurs with a large number of...
Larval paragonimiasis is a parasitic disease caused by lung fluke larvae. Unlike the classic form of paragonimiasis, the larval form occurs with a large number of clinical manifestations. However, this fact only complicates the diagnosis of larval paragonimiasis, for the abundance of clinical manifestations results in the misdiagnosis of other diseases. Another feature of this form of paragonimiasis is the tendency to generalize and mimic the clinical presentation of malignant neoplasms. The performed diagnostic measures failed to give an accurate view of the nature of the disease, therefore diagnostic thoracoscopy was carried out and biopsy specimens were taken from the subpleural region of dissemination, followed by urgent histologic examination suggestive of glandular cancer. This circumstance became the reason for atypical resection of the affected portion, which was done; however, the patient died from pulmonary thromboembolism on postoperative day 2. The main diagnosis of chronic pulmonary generalized paragonimiasis (cystic and pneumosclerotic phases) with neoplastic syndrome was posthumously made.
Topics: Animals; Diagnosis, Differential; Humans; Larva; Lung; Lung Neoplasms; Paragonimiasis
PubMed: 29697674
DOI: 10.17116/patol201880260-63 -
Stroke Nov 2014We retrospectively analyzed the clinical and imaging characteristics, diagnosis, and treatment outcomes of 10 patients with hemorrhagic cerebral paragonimiasis (CP), and...
BACKGROUND AND PURPOSE
We retrospectively analyzed the clinical and imaging characteristics, diagnosis, and treatment outcomes of 10 patients with hemorrhagic cerebral paragonimiasis (CP), and we evaluated the influence of Paragonimus infection on cerebrovascular damage.
METHODS
Ten patients (7 male and 3 female; median age 15.7 years, range 4-46 years) with hemorrhagic CP were diagnosed between April 2009 and January 2013. All patients underwent the head computed tomography scans and 9 patients underwent MRI examinations. Four patients underwent computed tomographic angiography, magnetic resonance angiography, and digital subtraction angiography. Liquid-based cytological examination of cerebrospinal fluid was performed in 7 patients. Follow-up examinations were performed for 9 cases for a period of 12 to 62 months.
RESULTS
Hemorrhagic CP accounted for 37% of CP cases (10/27). No patients were initially diagnosed with CP. The major symptoms of hemorrhagic CP included acute headache, vomiting, hemiparalysis, epilepsy, blurred vision, sensory impairment, and tinnitus. Four cases were surgically treated. Most symptoms markedly improved, but fine motor dysfunction and mental dysfunction remained in 3 surgical patients.
CONCLUSIONS
Hemorrhagic stroke typically occurred during the acute stage and in the early stages of further Paragonimus migration. Delay of treatment increased the risk of initial and recurrent stroke.
Topics: Adolescent; Adult; Cerebral Hemorrhage; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Male; Middle Aged; Paragonimiasis; Retrospective Studies; Young Adult
PubMed: 25270625
DOI: 10.1161/STROKEAHA.114.007267 -
Journal of Computer Assisted Tomography 1999We describe a case of retroperitoneal paragonimiasis presenting as periureteral masses. CT showed a conglomerate of enhancing nodules with subtle low attenuation in the... (Review)
Review
We describe a case of retroperitoneal paragonimiasis presenting as periureteral masses. CT showed a conglomerate of enhancing nodules with subtle low attenuation in the center at the left iliac fossa and clustered, ring-like, enhancing lesions at the left renal hilum. When a retroperitoneal conglomerate of ring-like, enhancing lesions in association with pleuropulmonary disease suggestive of paragonimiasis can be found in endemic regions or in migrants from those regions, one may expect ectopic-retroperitoneal paragonimiasis.
Topics: Abdomen; Animals; Biopsy, Needle; Diagnosis, Differential; Female; Humans; Middle Aged; Paragonimiasis; Paragonimus; Parasite Egg Count; Radiography, Abdominal; Retroperitoneal Space; Tomography, X-Ray Computed; Ultrasonography; Ureteral Diseases
PubMed: 10524848
DOI: 10.1097/00004728-199909000-00009 -
Medicine Jun 2017Paragonimiasis infection has no specific symptoms or typical radiologic findings, leading to the possibility of misdiagnosis. Thus, the objective of this study was to...
BACKGROUND
Paragonimiasis infection has no specific symptoms or typical radiologic findings, leading to the possibility of misdiagnosis. Thus, the objective of this study was to analyze clinical and radiological features, and treatment outcome of paragonimiasis in children in Southwest China to improve the awareness of this disease.
METHODS
We retrospectively reviewed the records of children diagnosed with paragonimiasis in West China Second University Hospital between 2005 and 2016. The confirmed diagnosis of paragonimiasis was based on epidemiology history and seropositivity for paragonimiasis and/or detection of paragonimus eggs. Clinical, laboratory, and imaging findings of patients were examined in order to summarize risk factors, clinical characteristics, and treatment outcomes of these patients.
RESULTS
A total of 123 patients were included; of them 112 (91.1%) lived in villages and 72 (58.5%) had a history of consuming freshwater crabs. Patients with paragonimiasis most frequently showed respiratory symptoms, including cough (26.0%, 32/123) and tachypnea (16.3%, 20/123), and gastrointestinal symptoms, including abdominal pain (26.8%, 33/123), abdominal distention (22.8%, 28/123), and vomiting (13.0%, 16/123). Laboratory examination showed elevated white blood cell (WBC) counts in the peripheral blood in 89 (72.4%) patients and eosinophilia in 102 (82.9%) patients. Tuberculosis (TB) coinfection was found in 4 (3.3%) patients. Main imaging findings included: effusions (90.4%), lymphadenopathy (40.4%), pulmonary ground-glass opacities (36.2%), cystic lesions (18.1%), and pleural thickening (17.0%). Twenty-nine patients (23.6%) received more than 1 course of praziquantel (PZQ). Additionally, 4 (19.0%) of 21 patients who were discharged from the hospital without complete treatment required rehospitalization for residual serous effusions. Moreover, patients from pericardial effusion group showed longer hospital stays and less elevated WBC counts than those from nonpericardial effusion group.
CONCLUSION
Paragonimiasis should be considered in patients from endemic areas, especially in those with gastrointestinal and/or respiratory symptoms, elevated WBC count, eosinophilia, and serous effusions. Additionally, longer hospital stay may be necessary in cases of paragonimiasis associated with pericardial effusions.
Topics: Adolescent; Anthelmintics; Biomarkers; Child; Child, Preschool; China; Early Diagnosis; Endemic Diseases; Enzyme-Linked Immunosorbent Assay; Female; Humans; Infant; Length of Stay; Male; Paragonimiasis; Patient Readmission; Pericardial Effusion; Praziquantel; Retrospective Studies; Shellfish
PubMed: 28640131
DOI: 10.1097/MD.0000000000007265 -
The Korean Journal of Gastroenterology... Oct 2023In Korea, the prevalence of paragonimiasis has decreased markedly since 1970 and is now rarely encountered. Although the lung is the primary site of paragonimiasis,...
In Korea, the prevalence of paragonimiasis has decreased markedly since 1970 and is now rarely encountered. Although the lung is the primary site of paragonimiasis, ectopic infestation can occur in other sites. The central nervous system is the most commonly involved ectopic site, accounting for only approximately 1% of all paragonimiasis patients. Therefore, the liver is an extremely rare site of ectopic infestation. The authors experienced the case of a 55-year-old female with hepatic paragonimiasis who presented with abdominal colicky pain.
Topics: Female; Humans; Middle Aged; Paragonimiasis; Liver; Abdominal Pain; Abdomen; Lung
PubMed: 37876259
DOI: 10.4166/kjg.2023.090 -
Paediatrics and International Child... Nov 2018An 11-year-old boy collapsed during morning assembly at his junior high school. The automated external defibrillator detected ventricular fibrillation and provided shock...
An 11-year-old boy collapsed during morning assembly at his junior high school. The automated external defibrillator detected ventricular fibrillation and provided shock delivery. He was successfully resuscitated and reverted to sinus rhythm. Electrocardiography showed ST-T elevation in the precordial leads. Echocardiography and angiography demonstrated akinesia of the apex and mid-wall of the left ventricle with preserved contraction of the basal segments, which suggested Takotsubo cardiomyopathy. The patient and his family had often eaten uncooked crab, and his father had a past history of infection with Paragonimiasis westermani. The patient had had a persistent cough and chest pain for several weeks. Chest radiograph showed cystic cavities in the left upper lung. Microbiological examination of the sputum demonstrated an egg of P. westermani and immunological assay showed a raised antibody titre to P. westermani. On the12th day of admission, he developed seizures, and magnetic resonance imaging demonstrated cerebral involvement. After the administration of praziquantel for 3 days, the clinical manifestations improved immediately, and echocardiography normalised within 3 weeks. The patient was discharged on the 32nd day + and follow-up was normal. Takotsubo cardiomyopathy following a potentially fatal arrhythmia is a rare cardiac complication associated with pulmonary and central nervous system infection by P. westermani.
Topics: Angiography; Animals; Antiparasitic Agents; Central Nervous System Parasitic Infections; Child; Echocardiography; Electrocardiography; Humans; Magnetic Resonance Imaging; Male; Microbiological Techniques; Paragonimiasis; Paragonimus westermani; Praziquantel; Radiography, Thoracic; Takotsubo Cardiomyopathy; Treatment Outcome
PubMed: 28884631
DOI: 10.1080/20469047.2017.1371482 -
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 -
The Korean Journal of Parasitology Dec 2012Paragonimiasis is a parasitic disease caused by the lung fluke, Paragonimus spp. Lung flukes may be found in various organs, such as the brain, peritoneum, subcutaneous...
Paragonimiasis is a parasitic disease caused by the lung fluke, Paragonimus spp. Lung flukes may be found in various organs, such as the brain, peritoneum, subcutaneous tissues, and retroperitoneum, other than the lungs. Abdominal paragonimiasis raises a considerable diagnostic challenge to clinicians, because it is uncommon and may be confused with other abdominopelvic inflammatory diseases, particularly peritoneal tuberculosis, and peritoneal carcinomatosis. Also, subcutaneous paragonimiasis does not easily bring up clinical suspicion, due to its rarity. We herein report 2 cases of abdominal paragonimiasis and 1 case of subcutaneous paragonimiasis in Korea.
Topics: Abdominal Cavity; Animals; Biopsy, Fine-Needle; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Paragonimiasis; Paragonimus; Radiography; Republic of Korea; Subcutaneous Tissue
PubMed: 23230333
DOI: 10.3347/kjp.2012.50.4.345