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International Journal of Infectious... Aug 2020Next-generation sequencing (NGS) is an emerging method with the potential of pan-pathogen screening. This study described a case of eosinophilic meningitis (EoM) with...
Next-generation sequencing (NGS) is an emerging method with the potential of pan-pathogen screening. This study described a case of eosinophilic meningitis (EoM) with enzyme-linked immunosorbent assay (ELISA)-negative results for Angiostrongylus cantonensis (A. cantonensis), Trichinella spiralis and Paragonimus westermani and a positive identification of A. cantonensis by NGS in the cerebrospinal fluid.
Topics: Angiostrongylus cantonensis; Animals; Enzyme-Linked Immunosorbent Assay; Eosinophilia; High-Throughput Nucleotide Sequencing; Humans; Male; Meningitis; Strongylida Infections
PubMed: 32502661
DOI: 10.1016/j.ijid.2020.05.108 -
Internal Medicine (Tokyo, Japan) Aug 2020An asymptomatic 47-year-old woman was admitted with pleural effusion and pulmonary infiltrates 1 month after ingesting raw wild boar and deer meat. Both her blood and...
An asymptomatic 47-year-old woman was admitted with pleural effusion and pulmonary infiltrates 1 month after ingesting raw wild boar and deer meat. Both her blood and pleural fluid were eosinophilic. Thoracoscopy revealed multiple nodules of the pleura, and biopsy samples of the nodules showed necrosis with epithelioid cell granulomas. An enzyme-linked immunosorbent assay was positive for antibodies against Paragonimus westermani, and the patient was successfully treated with praziquantel. This is the first reported case of pulmonary or pleuropulmonary paragonimiasis where several pleural nodules were observed. The detection of pleural nodules on thoracoscopy can contribute to the prompt and accurate diagnosis of paragonimiasis.
Topics: Animals; Deer; Enzyme-Linked Immunosorbent Assay; Female; Humans; Meat; Middle Aged; Paragonimiasis; Paragonimus westermani; Pleura; Pleural Effusion; Praziquantel; Respiratory Tract Infections; Sus scrofa; Thoracoscopy
PubMed: 32350198
DOI: 10.2169/internalmedicine.4457-20 -
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 -
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 -
PeerJ 2019We present the complete mitochondrial genome of Miyazaki, 1939 and compare its features with those of previously reported mitochondrial genomes of the pathogenic...
We present the complete mitochondrial genome of Miyazaki, 1939 and compare its features with those of previously reported mitochondrial genomes of the pathogenic lung-fluke, , and other members of the genus. The circular mitochondrial DNA molecule of the single fully sequenced individual of was 14,818 bp in length, containing 12 protein-coding, two ribosomal RNA and 22 transfer RNA genes. As is common among trematodes, an gene was absent from the mitogenome of and the 5' end of overlapped with the 3' end of by 40 bp and four forms/strains of from South Korea and India, exhibited remarkably different base compositions and hence codon usage in protein-coding genes. In the fully sequenced individual, the non-coding region started with two long identical repeats (292 bp each), separated by . These were followed by an array of six short tandem repeats (STR), 117 bp each. Numbers of the short tandem repeats varied among individuals. A phylogenetic tree inferred from concatenated mitochondrial protein sequences of 50 strains encompassing 42 species of trematodes belonging to 14 families identified a monophyletic Paragonimidae in the class Trematoda. Characterization of additional mitogenomes in the genus will be useful for biomedical studies and development of molecular tools and mitochondrial markers for diagnostic, identification, hybridization and phylogenetic/epidemiological/evolutionary studies.
PubMed: 31259095
DOI: 10.7717/peerj.7031 -
Memorias Do Instituto Oswaldo Cruz 2019The genetic information of ancient Paragonimus westermani, the oriental lung fluke infecting over 20 million people worldwide, has not been thoroughly investigated thus...
The genetic information of ancient Paragonimus westermani, the oriental lung fluke infecting over 20 million people worldwide, has not been thoroughly investigated thus far. We analysed genetic markers (COI and ITS2) of P. westermani from coprolite specimens (n = 6) obtained from 15th to 18th century Korean mummies. Our results indicated that all P. westermani sequences were generally distinct from the other species of the genus Paragonimus. The sequences were clustered into three groups: Group I for East Asia; Group II for South and Southeast Asia; and Group III for India and Sri Lanka. In this study, we found that ancient P. westermani sequences in Korea belong to Group I, adding invaluable information to the existing knowledge of Paragonimus paleogenetics.
Topics: Animals; Asia; DNA, Helminth; DNA, Ribosomal Spacer; Electron Transport Complex IV; Feces; Humans; Mummies; Paleodontology; Paragonimus westermani; Parasite Egg Count; Phylogeny
PubMed: 31116227
DOI: 10.1590/0074-02760180595 -
GigaScience Jan 2019Foodborne infections caused by lung flukes of the genus Paragonimus are a significant and widespread public health problem in tropical areas. Approximately 50...
BACKGROUND
Foodborne infections caused by lung flukes of the genus Paragonimus are a significant and widespread public health problem in tropical areas. Approximately 50 Paragonimus species have been reported to infect animals and humans, but Paragonimus westermani is responsible for the bulk of human disease. Despite their medical and economic importance, no genome sequence for any Paragonimus species is available.
RESULTS
We sequenced and assembled the genome of P. westermani, which is among the largest of the known pathogen genomes with an estimated size of 1.1 Gb. A 922.8 Mb genome assembly was generated from Illumina and Pacific Biosciences (PacBio) sequence data, covering 84% of the estimated genome size. The genome has a high proportion (45%) of repeat-derived DNA, particularly of the long interspersed element and long terminal repeat subtypes, and the expansion of these elements may explain some of the large size. We predicted 12,852 protein coding genes, showing a high level of conservation with related trematode species. The majority of proteins (80%) had homologs in the human liver fluke Opisthorchis viverrini, with an average sequence identity of 64.1%. Assembly of the P. westermani mitochondrial genome from long PacBio reads resulted in a single high-quality circularized 20.6 kb contig. The contig harbored a 6.9 kb region of non-coding repetitive DNA comprised of three distinct repeat units. Our results suggest that the region is highly polymorphic in P. westermani, possibly even within single worm isolates.
CONCLUSIONS
The generated assembly represents the first Paragonimus genome sequence and will facilitate future molecular studies of this important, but neglected, parasite group.
Topics: Animals; Genome Size; Genome, Helminth; Genome, Mitochondrial; High-Throughput Nucleotide Sequencing; Molecular Sequence Annotation; Paragonimus westermani; Phylogeny; Sequence Homology, Nucleic Acid; Whole Genome Sequencing
PubMed: 30520948
DOI: 10.1093/gigascience/giy146 -
Infectious Diseases of Poverty Oct 2018Paragonimiasis, caused by helminths of the genus Paragonimus spp., is a neglected tropical disease. Human suffering from paragonimiasis is often misunderstood and its... (Review)
Review
BACKGROUND
Paragonimiasis, caused by helminths of the genus Paragonimus spp., is a neglected tropical disease. Human suffering from paragonimiasis is often misunderstood and its quantification by the disability weight of the disability-adjusted life years largely varies in different global burden of disease (GBD) estimates. This paper is to systematically review clinical paragonimiasis cases and requantify the disability weight of human paragonimiasis.
METHODS
A systematic analysis was conducted using articles from the following databases: PubMed, Institute for Scientific Information Web of Science, China National Knowledge Infrastructure, the Chinese scientific journal databases Wanfang Data and CQVIP, Africa Journal Online, and the System for Information on Grey Literature in Europe. Search terms were the combination of "paragonim*" with "clinical" or "infection". Only articles fulfilling the following conditions were recruited for this study: the occurrence of clinical signs and symptoms of paragonimiasis in human beings were reported; diagnosis was confirmed; no comorbidities were reported; the reviewed clinical cases or epidemiological findings were not already included in any other articles. The information and frequencies of paragonimiasis outcomes from included articles using predefined data fields were extracted two times by two separate individuals. Outcome disability weights were selected mainly from the GBD 2004 and GBD 2013 datasets. Frequencies and disability weights of paragonimiasis outcomes were modelled into a decision tree using the additive approach and multiplicative approach, respectively. Monte Carlo simulations were run 5000 times for an uncertainty analysis.
RESULTS
The disability weight estimates of paragonimiasis were simulated with 5302 clinical cases from 80 general articles. The overall disability weight was estimated at 0.1927 (median 0.1956) with a 95% uncertainty interval (UI) of 0.1632-0.2378 using the additive approach, and 0.1791 (median 0.1816) with a 95% UI of 0.1530-0.2182 using the multiplicative approach. The simulated disability weights of Paragonimus westermani cases were higher than that of P. skrjabini cases. Lung outcomes and headache were the top two contributors to disability weight for both species.
CONCLUSIONS
The use of paragonimiasis disability weight needs to be reconsidered with regard to availability of morbidity data and species variation. Calculating the disease burden of paragonimiasis requires further modification and thus has considerable implications for public health prioritization in research, monitoring, and control.
Topics: Animals; Cost of Illness; Decision Making; Decision Trees; Disabled Persons; Humans; Paragonimiasis; Paragonimus; Patient Outcome Assessment
PubMed: 30342548
DOI: 10.1186/s40249-018-0485-5 -
Mitochondrial DNA. Part B, Resources Jun 2018In this study, the complete mitochondrial genome of human lung fluke, , was recovered through Illumina sequencing data. This complete mitochondrial genome of is...
In this study, the complete mitochondrial genome of human lung fluke, , was recovered through Illumina sequencing data. This complete mitochondrial genome of is 13,927 bp in length and has a base composition of A (16.6%), T (41.8%), C (13.%), and G (28.4%), demonstrating an obvious bias of high AT content (58.4%). The mitochondrial genome contains a typically conserved structure, encoding 12 protein-coding genes (PCGs), 22 transfer RNA genes (tRNA), 2 ribosomal RNA genes (12S rRNA and 16S rRNA), and a control region (D-loop region). All PCGs were located on the H-strand. ND4 gene and ND4L gene were overlapped by 39 bp. The nucleotide sequence of 12 PCGs of and other 10 parasite species were used for phylogenetic analysis. The result indicated a relative close relationship with species (AF219379.2).
PubMed: 33474294
DOI: 10.1080/23802359.2018.1483763 -
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