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Internal Medicine (Tokyo, Japan) Jan 2019A 43-year-old woman was referred to our hospital with peripheral blood hypereosinophilia and abnormal chest X-ray findings. Her pleural effusion revealed...
A 43-year-old woman was referred to our hospital with peripheral blood hypereosinophilia and abnormal chest X-ray findings. Her pleural effusion revealed hypereosinophilia and a low glucose level. She was diagnosed with pulmonary paragonimiasis based on an elevated antibody level of Paragonimiasis westermani. Although she had no medical history of allergic disorders, a pulmonary function test revealed bronchodilator reversibility. After praziquantel therapy, her symptoms, hypereosinophilia in peripheral blood, and pleural effusion were improved. A repeated pulmonary function test after praziquantel therapy showed a negative bronchodilator response. Pulmonary paragonimiasis may induce bronchodilator reversibility during the acute phase of infection.
Topics: Acute Disease; Adult; Anthelmintics; Bronchi; Bronchodilator Agents; Eosinophilia; Female; Humans; Lung Diseases, Parasitic; Paragonimiasis; Pleural Effusion; Praziquantel; Radiography, Thoracic; Respiratory Function Tests
PubMed: 30146559
DOI: 10.2169/internalmedicine.0401-17 -
International Journal of Infectious... Aug 2018The serological diagnosis of human infection with Angiostrongylus cantonensis remains problematic because there are no commercially available validated tests. Most...
OBJECTIVES
The serological diagnosis of human infection with Angiostrongylus cantonensis remains problematic because there are no commercially available validated tests. Most laboratories use domestically prepared tests such as the enzyme-linked immunosorbent assay (ELISA) or immunoblotting. Since laboratory facilities are not always available in endemic areas, we developed and assessed a rapid lateral flow immunochromatographic assay (AcQuick Test) to detect anti-A. cantonensis antibodies in human serum.
METHODS
The test device was assembled with purified 31-kDa glycoprotein as diagnostic antigen and with gold-labelled anti-human immunoglublin-G as the detector reagent. A total of 97 serum samples were tested - 19 samples from clinically diagnosed patients with detectable A. cantonensis-specific antibody in immunoblotting; 43 samples from patients with other parasitic diseases, i.e. gnathostomiasis (n=13), toxocariasis (n=2), trichinellosis (n=2), hookworm infection (n=4), filariasis (n=5), cysticercosis (n=9), paragonimiasis (n=2), opisthorchiasis (n=3), and malaria (n=3); and 35 samples from normal healthy subjects.
RESULTS
The sensitivity, specificity, positive predictive value and negative predictive value of AcQuick Test to detect anti-A. cantonensis specific antibodies in serologically confirmed angiostrongyliasis cases, were 100%, 98.72%, 95% and 100%, respectively. Positive AcQuick was observed in 1 of 4 cases with hookworm infections. No positive AcQuick was observed in cases with other parasitic diseases, and the individual healthy subjects.
CONCLUSIONS
AcQuick Test is rapid, highly sensitive and specific, and easy to perform without additional equipment or ancillary supplies. It yields results that are interpreted visually, and possesses a long shelf-life at room temperature. Thus, it can be applied as an additional test for clinical diagnostic support of angiostrongyliasis either in conventional laboratories or for remote areas where laboratory infrastructure is not available.
Topics: Angiostrongylus cantonensis; Animals; Antibodies, Helminth; Chromatography, Affinity; Humans; Serologic Tests; Strongylida Infections
PubMed: 29908250
DOI: 10.1016/j.ijid.2018.06.005 -
Parasites & Vectors May 2018Members of the genus Paragonimus require at least three hosts in their life-cycles. The obligatory first intermediate hosts are freshwater snails. In Vietnam, although...
BACKGROUND
Members of the genus Paragonimus require at least three hosts in their life-cycles. The obligatory first intermediate hosts are freshwater snails. In Vietnam, although seven Paragonimus species have been recorded, the natural first intermediate hosts of almost all species have not been confirmed. The aim of this study was, therefore, to investigate snail hosts of Paragonimus species in Vietnam, and to identify Paragonimus species at intramolluscan stages.
METHODS
Freshwater snails were collected from streams in Yen Bai and Quang Tri Provinces, where high prevalences of Paragonimus metacercariae in crab hosts have been reported. Snails were morphologically identified and then examined individually for Paragonimus cercariae using shedding and crushing methods. Chaetomicrocercous cercariae, the morphological class to which Paragonimus cercariae belong, were collected for morphological description and molecular species identification by analyses of ITS2 sequences. The infected snail species were identified based on analyses of nucleotide sequences of the cox1 gene.
RESULTS
Three snail species were found to be infected with Paragonimus cercariae at low infection rates, ranging between 0.07-1.0%. The molecular analyses identified them as Sulcospira quangtriensis and 2 species of subfamily Triculinae. In a phylogenetic tree, these two triculine snails were related to the genera Gammatricula and Tricula with low posterior probabilities. Thus we named them as Triculinae sp. 1 and Triculinae sp. 2. Cercariae from the three snail species, Sulcospira quangtriensis, Triculinae sp. 1 and Triculinae sp. 2, were molecularly identified as Paragonimus westermani, P. heterotremus and P. proliferus, respectively. The cercariae of the three species are morphologically similar to each other, but their daughter rediae can be distinguished by the length of the intestine and the number of cercariae per redia. The rediae of P. westermani have a long intestine and each contain 6-8 cercariae. In contrast, those of P. heterotremus and P. proliferus have a short intestine and each redia contain 10-12 and 5-6 cercariae, respectively.
CONCLUSIONS
Three snail species, Sulcospira quangtriensis, Triculinae sp. 1 and Triculinae sp. 2, serve as the first intermediate hosts of P. westermani, P. heterotremus and P. proliferus, respectively, in Vietnam. The length of the intestine of rediae and the number of cercariae per redia are valuable characteristics for distinguishing between larvae of these Paragonimus species.
Topics: Animals; Brachyura; Geography; Host Specificity; Larva; Life Cycle Stages; Metacercariae; Paragonimiasis; Paragonimus; Phylogeny; Snails; Vietnam
PubMed: 29848373
DOI: 10.1186/s13071-018-2897-2 -
Parasites & Vectors May 2018Paragonimus heterotremus is the main causative agent of paragonimiasis in Thailand. In Western blot diagnostic assays for paragonimiasis, the 35 kDa band present in...
BACKGROUND
Paragonimus heterotremus is the main causative agent of paragonimiasis in Thailand. In Western blot diagnostic assays for paragonimiasis, the 35 kDa band present in crude P. heterotremus somatic extracts represents one of the known diagnostic bands. This study aimed to use a P. heterotremus cDNA library to create a recombinant version of this antigen for use in immunodiagnosis of paragonimiasis.
METHODS
To accomplish this aim a cDNA expression library was constructed from adult worm mRNA and immuno-screened using antibodies from mice that had been immunized with the 35 kDa antigen. Screening resulted in the identification of an immunoreactive protein encoded by clone CE3, which contained an inserted sequence composed of 1292 base pairs. This clone was selected for use in the construction of a recombinant P. heterotremus protein because of its similarity to proactivator polypeptide. For recombinant protein expression, the CE3 gene sequence was inserted into the plasmid vector pRset and the resulting product had the expected molecular weight of 35 kDa. An IgG-ELISA based on the CE3 recombinant protein was evaluated by using sera from healthy individuals, from patients with paragonimiasis and other parasitic infections. This ELISA was performed by using human sera diluted at 1:2000, an optimized antigen concentration of 1 μg/ml, and anti-human IgG diluted at 1:4000.
RESULTS
The cut-off optical density value was set as the mean + 2 standard deviations (0.54), which resulted in the test having a sensitivity of 88.89% and a specificity of 95.51%. The recombinant antigen could react with antibodies from P. heterotremus, P. pseudoheterotremus and P. westermani infections. Cross-reactivity occurred with a few cases of Blastocystis hominis infection (2/3), Bancroftian filariasis (1/10), opisthorchiasis (3/10), strongyloidiasis (4/10) and neurocysticercosis (1/11).
CONCLUSIONS
Given the high test sensitivity and specificity, reflected in the low level of heterologous infection cross-reactivity (11/215 serum samples), observed in the IgG-ELISA, this 35 kDa antigen may be useful for the detection of paragonimiasis.
Topics: Animals; Antibodies, Helminth; Antigens, Helminth; Cross Reactions; Humans; Immunoglobulin G; Paragonimiasis; Paragonimus; Recombinant Proteins; Sensitivity and Specificity; Serologic Tests
PubMed: 29843786
DOI: 10.1186/s13071-018-2878-5 -
The Korean Journal of Parasitology Apr 2018To determine that sp. is actively transmitted in a tropical area of the Pacific region of Ecuador where human cases of pulmonary paragonimiasis have recently been...
To determine that sp. is actively transmitted in a tropical area of the Pacific region of Ecuador where human cases of pulmonary paragonimiasis have recently been documented, a total of 75 freshwater crabs were collected from 2 different streams in the Pedernales area of Manabí Province, Ecuador. All collected crabs were identified as based on morphological characteristics of the male gonopods. The hepatopancreas of each crab was examined by compressing it between 2 glass plates followed by observation under a stereomicroscope. Excysted metacercariae were detected in 39 (52.0%) crabs and their densities varied from 1 to 32 per infected crab. There was a positive relationship between crab size and metacercarial density. Sequences of the second internal transcribed spacer region of the ribosomal RNA gene of the metacercariae obtained in this study were identical to those of deposited in the DDBJ/EMBL/GenBank database. Thus, the present study is the first to confirm that the crab species is the second intermediate host of in Manabí Province, Ecuador. Because this crab might be the possible source of human infections in this area, residents should pay attention to improper crab-eating habits related with a neglected parasitic disease, i.e., paragonimiasis.
Topics: Animals; Decapoda; Ecuador; Female; Foodborne Diseases; Host-Parasite Interactions; Humans; Male; Metacercariae; Paragonimiasis; Paragonimus
PubMed: 29742874
DOI: 10.3347/kjp.2018.56.2.189 -
Infectious Diseases of Poverty Apr 2018Snail-borne parasitic diseases, such as angiostrongyliasis, clonorchiasis, fascioliasis, fasciolopsiasis, opisthorchiasis, paragonimiasis and schistosomiasis, pose risks... (Review)
Review
BACKGROUND
Snail-borne parasitic diseases, such as angiostrongyliasis, clonorchiasis, fascioliasis, fasciolopsiasis, opisthorchiasis, paragonimiasis and schistosomiasis, pose risks to human health and cause major socioeconomic problems in many tropical and sub-tropical countries. In this review we summarize the core roles of snails in the life cycles of the parasites they host, their clinical manifestations and disease distributions, as well as snail control methods.
MAIN BODY
Snails have four roles in the life cycles of the parasites they host: as an intermediate host infected by the first-stage larvae, as the only intermediate host infected by miracidia, as the first intermediate host that ingests the parasite eggs are ingested, and as the first intermediate host penetrated by miracidia with or without the second intermediate host being an aquatic animal. Snail-borne parasitic diseases target many organs, such as the lungs, liver, biliary tract, intestines, brain and kidneys, leading to overactive immune responses, cancers, organ failure, infertility and even death. Developing countries in Africa, Asia and Latin America have the highest incidences of these diseases, while some endemic parasites have developed into worldwide epidemics through the global spread of snails. Physical, chemical and biological methods have been introduced to control the host snail populations to prevent disease.
CONCLUSIONS
In this review, we summarize the roles of snails in the life cycles of the parasites they host, the worldwide distribution of parasite-transmitting snails, the epidemiology and pathogenesis of snail-transmitted parasitic diseases, and the existing snail control measures, which will contribute to further understanding the snail-parasite relationship and new strategies for controlling snail-borne parasitic diseases.
Topics: Animals; Disease Vectors; Host-Parasite Interactions; Humans; Parasitic Diseases; Snails
PubMed: 29628017
DOI: 10.1186/s40249-018-0414-7 -
Chest Apr 2018A man in his 20s presented with 2 months of mild fatigue and intermittent hemoptysis of less than a tablespoon per episode. He was previously healthy and was on no...
A man in his 20s presented with 2 months of mild fatigue and intermittent hemoptysis of less than a tablespoon per episode. He was previously healthy and was on no medications. He denied fevers, night sweats, weight loss, wheezing, dyspnea, musculoskeletal symptoms, and rashes. He had emigrated from a South American country to the United States 3 years earlier. He worked as a groundskeeper but had no exposures to animals, mold, or dusts. He reported rare prior cigarette smoking with no history of alcohol or drug use. He was unsure whether he had received the Bacillus Calmette-Guérin vaccine.
Topics: Adult; Antinematodal Agents; Diagnosis, Differential; Dyspnea; Hemoptysis; Humans; Lung Diseases, Parasitic; Male; Paragonimiasis; Praziquantel; Tomography, X-Ray Computed; Tuberculosis, Pulmonary
PubMed: 29626974
DOI: 10.1016/j.chest.2017.09.018 -
Medicine Apr 2018Paragonimiasis is a parasitic disease caused by Paragonimus in the lungs; it can be divided into intrapulmonary type and extrapulmonary type. Adult patients with scrotal... (Review)
Review
RATIONALE
Paragonimiasis is a parasitic disease caused by Paragonimus in the lungs; it can be divided into intrapulmonary type and extrapulmonary type. Adult patients with scrotal paragnonimus are rarely seen clinically and not widely reported in the literature. Here, we report 2 cases of scrotal paragonimiasis in adults and their treatment process.
PATIENT CONCERNS
Two young males sought medical advice because of scrotal masses. Both patients had the previous history of eating uncooked river crabs and presented with palpable quasicircular nodules of about 1.5 × 1.0 cm in testicles, which were well-defined, resilient in tenderness. The bilateral inguinal lymph nodes were not enlarged.
DIAGNOSIS AND INTERVENTIONS
The 2 patients underwent scrotal mass resection; postoperative pathology examination confirmed scrotum paragonimiasis. Both the patients were administered praziquantel after operation.
OUTCOMES
They were followed up for 1 year and 4 years, respectively; both recovered well, free from recurrence. Scrotum color Doppler ultrasound examination found no obvious abnormality.
LESSONS
Adult patients with scrotum paragonimiasis are rarely seen clinically. Moreover, its clinical manifestations are not typical that leads to missed diagnosis and misdiagnosis. Diagnosis of the disease needs to combine with disease histories, manifestations, and relevant auxiliary examinations. But the diagnosis can be confirmed only by histopathological examination. The main method for treatment of scrotal paragonimiasis is antiparasitic treatment. However, health education is crucial to prevent this disease and relapse.
Topics: Adult; Genital Diseases, Male; Humans; Male; Paragonimiasis; Scrotum; Young Adult
PubMed: 29620658
DOI: 10.1097/MD.0000000000010328 -
Chinese Medical Journal Mar 2018
Topics: Clonorchiasis; Humans; Paragonimiasis
PubMed: 29483405
DOI: 10.4103/0366-6999.226079 -
Chinese Medical Journal Mar 2018
Topics: Clonorchiasis; Humans; Paragonimiasis
PubMed: 29483404
DOI: 10.4103/0366-6999.226078