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Scientific Reports Jan 2021Diagnosis of pediatric paragonimiasis is difficult because of its non-specific clinical manifestations. We retrospectively reviewed the records of pediatric...
Diagnosis of pediatric paragonimiasis is difficult because of its non-specific clinical manifestations. We retrospectively reviewed the records of pediatric paragonimiasis in Children's Hospital of Fudan University from January 2011 to May 2019. The confirmed diagnosis of paragonimiasis was based on positive anti-parasite serological tests from the local Center for Disease Control (CDC). A total of 11 patients (mean age: 7.7 ± 3.1, male-female ratio: 7:4) diagnosed as paragonimiasis were included. 81.8% were from endemic areas such as Sichuan and Yunnan, and 36% had a clear history of raw crab or crayfish consumption. The characteristic clinical features of pediatric paragonimiasis were eosinophilia (100%), pleural effusion (81.8%), hepatomegaly (54.5%), ascites (54.5%), and subcutaneous nodules (45.5%). Misdiagnosed with other diseases including tuberculosis (18.2%), pneumonia (9.1%), intracranial space-occupying lesions (9.1%) and brain abcess (9.1%) led to rehospitalization and prolonged hospitalization. For treatment, a 3-day course of 150 mg/kg praziquantel (PZQ) didn't show ideal treatment effectivity and 63.6% needed more than one course of PZQ, while triclabendazole in a total dose of 10 mg/kg had a better efficacy to stubborn manifestations. This study indicated that pediatric paragonimiasis was often misdiagnosed, and the treatment with a 3-day course of 150 mg/kg PZQ had a high rate of failure.
Topics: Animals; Anthelmintics; Child; Child Health; China; Diagnosis, Differential; Diagnostic Errors; Female; Hospitals; Humans; Lung Diseases, Parasitic; Male; Paragonimiasis; Paragonimus; Pleural Effusion; Praziquantel; Retrospective Studies; Risk Factors
PubMed: 33479468
DOI: 10.1038/s41598-021-81694-7 -
The Journal of Veterinary Medical... Mar 2021Paragonimiasis is a particular foodborne parasitic disease that is endemic to southern Kyushu, including Kagoshima Prefecture, Japan. We previously detected Paragonimus...
Paragonimiasis is a particular foodborne parasitic disease that is endemic to southern Kyushu, including Kagoshima Prefecture, Japan. We previously detected Paragonimus westermani triploid larvae in meat samples obtained from wild boars and sika deer hunted in Akune City, Kagoshima Prefecture. These mammals act as paratenic hosts and their meat is a source of human paragonimiasis. Paratenic host mammals and humans become infected with the lung fluke, P. westermani, following consumption of second intermediate hosts, freshwater crab species, namely, Geothelphusa dehaani or Sawagani in Japanese, and Eriocheir japonica or Mokuzugani in Japanese. Therefore, this study aimed to investigate the current infection status of P. westermani in freshwater crabs in Akune City. We collected freshwater crabs from 15 locations and found that the prevalence of P. westermani metacercariae was 1.6% for Sawagani (15 of 941 examined) and 22.1% for Mokuzugani (21 of 95 examined). Based on the morphological characterization of metacercariae and molecular analyses of the internal transcribed spacer 2 region and mitochondrial 16S rRNA gene region using PCR-restriction fragment length polymorphism and sequencing, all metacercariae were identified as the triploid form of P. westermani. These results indicate that Sawagani and Mokuzugani serve as second intermediate hosts to maintain the life cycle of triploid P. westermani. Further, infection in crabs potentially leads to subsequent P. westermani infections in wild mammals, including wild boars and sika deer, both of which are considered important types of game meat in Japan.
Topics: Animals; Brachyura; Deer; Fresh Water; Japan; Metacercariae; Paragonimus; Paragonimus westermani; RNA, Ribosomal, 16S; Sus scrofa; Swine
PubMed: 33473059
DOI: 10.1292/jvms.20-0576 -
Journal of Gastroenterology and... Apr 2021
Topics: Abdominal Pain; Adult; Animals; Anti-Bacterial Agents; Drainage; Eosinophils; Female; Fever; Hepatectomy; Humans; Liver; Liver Abscess; Liver Diseases, Parasitic; Paragonimiasis; Paragonimus; Tomography, X-Ray Computed; Treatment Failure
PubMed: 33458841
DOI: 10.1111/jgh.15383 -
Neurology May 2021
Topics: Animals; Brain; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Paragonimiasis; Paragonimus
PubMed: 33441457
DOI: 10.1212/WNL.0000000000011492 -
Parasitology Research Feb 2021Paragonimiasis is a foodborne trematode infection that affects 23 million people, mainly in Asia. Lung fluke infections lead frequently to chronic cough with fever and...
Paragonimiasis is a foodborne trematode infection that affects 23 million people, mainly in Asia. Lung fluke infections lead frequently to chronic cough with fever and hemoptysis, and are often confused with lung cancer or tuberculosis. Paragonimiasis can be efficiently treated with praziquantel, but diagnosis is often delayed, and patients are frequently treated for other conditions. To improve diagnosis, we selected five Paragonimus kellicotti proteins based on transcriptional abundance, recognition by patient sera, and conservation among trematodes and expressed them as His-fusion proteins in Escherichia coli. Sequences for these proteins have 76-99% identity with amino acid sequences for orthologs in the genomes of Paragonimus westermani, Paragonimus heterotremus, and Paragonimus miyazakii. Immunohistology studies showed that antibodies raised to four recombinant proteins bound to the tegument of adult P. kellicotti worms, at the parasite host interface. Only a known egg antigen was absent from the tegument but present in developing and mature eggs. We evaluated the diagnostic potential of these antigens by Western blot with sera from patients with paragonimiasis (from MO and the Philippines), fascioliasis, and schistosomiasis, and with sera from healthy North American controls. Two recombinant proteins (a cysteine protease and a myoglobin) showed the highest sensitivity and specificity as diagnostic antigens, and they detected antibodies in sera from paragonimiasis patients with early or mature infections. In contrast, antibodies to egg yolk ferritin appeared to be specific marker for patients with adult fluke infections that produce eggs. Our study has identified and localized antigens that are promising for serodiagnosis of human paragonimiasis.
Topics: Adult; Animals; Anthelmintics; Antibodies, Helminth; Antigens, Helminth; Asia; Gerbillinae; Humans; Immunohistochemistry; Paragonimiasis; Paragonimus; Paragonimus westermani; Praziquantel; Recombinant Proteins; Sensitivity and Specificity; Serologic Tests
PubMed: 33415393
DOI: 10.1007/s00436-020-06990-z -
Parasitology International Apr 2021We encountered an outbreak of paragonimiasis among Cambodian technical intern trainees (TITs) at a food-processing factory in Fukuoka, Japan. The patients were...
We encountered an outbreak of paragonimiasis among Cambodian technical intern trainees (TITs) at a food-processing factory in Fukuoka, Japan. The patients were 20-28 years old, seven females and two males, who had been in Japan for one to four years. All of them had consumed raw or undercooked Japanese mitten crab they purchased at a local grocery store near their training place. CT images showed multiple lesions not only in the lungs but in the extrapulmonary organs as well, such as subcutaneous tissues, abdominal muscles, and mesentery, in most of the patients. Their medical records indicated that all of them acquired infection in Japan, not in Cambodia. Diagnosis was made serologically and the patients were treated with praziquantel successfully. Foreign workers and TITs are increasing in Japan so rapidly, that food borne-infections, including paragonimiasis, should be considered in people from developing countries who have exotic dietary habits.
Topics: Adult; Animals; Cambodia; Disease Outbreaks; Female; Humans; Japan; Lung; Lung Diseases, Parasitic; Male; Paragonimiasis; Paragonimus westermani; Young Adult
PubMed: 33388385
DOI: 10.1016/j.parint.2020.102279 -
Respiratory Medicine Case Reports 2020Paragonimiasis, or Oriental lung fluke is a parasitic infestation seen in Asia, Africa and South America which is spread by the consumption of crabs and crayfish. To...
Paragonimiasis, or Oriental lung fluke is a parasitic infestation seen in Asia, Africa and South America which is spread by the consumption of crabs and crayfish. To date four cases have been reported from Nepal. Here, we report a case of paragonimiasis in a young male from Kathmandu valley who presented with symptoms of fever, on and off for 1 month, shortness of breath and cough. He was found to have pleural effusion. Sputum examination did not reveal acid fast bacilli, However, based on clinical features, he was started on antitubercular treatment. There was initial improvement, but later, he continued to have cough and hemoptysis over the next 2 years and on subsequent High-Resolution Computerized Tomography (HRCT) he was found to have a cavitary lung lesion in the superior segment of lower lobe of left lung. A possibility of aspergillosis was considered for which he underwent a lobectomy. The gross examination of the lung showed a small cavity measuring 5 mm which revealed on histology a parasitic structure with serous glands within it. In addition, there were many foreign body granulomas with ova within them. A diagnosis of paragonimiasis was made and the patient was started on Praziquantal. He recovered well and is currently asymptomatic. We can learn from this case that the signs and symptoms of paragonimiasis mimic that of tuberculosis and the mistaken diagnosis can lead to unnecessary treatment, prolonged morbidity and loss of time and resources.
PubMed: 33304807
DOI: 10.1016/j.rmcr.2020.101298 -
Sudebno-meditsinskaia Ekspertiza 2020Is to draw the attention of forensic experts and histologists to the problem of infectious diseases occurring with the formation of granulomas. Was reviewed the general...
Is to draw the attention of forensic experts and histologists to the problem of infectious diseases occurring with the formation of granulomas. Was reviewed the general patterns of granulomatous diseases, as well as the peculiarities of pathomorphosis in helminthiasis (schistosomiasis, paragonimiasis, onchocerciasis, dirofilariasis, ascariasis, cysticercosis), mycoses (cryptococcosis, chromomycosis, coccidioidosis) and protozoal diseases, toxosomes. The article includes photomicrographs from the authors' personal archive, including those collected during their work in African countries Text is based on scientific data from articles, monographs, educational literature, personal experience and cases of forensic medical practice.
Topics: Ascariasis; Helminthiasis; Humans; Inflammation; Mycoses; Schistosomiasis
PubMed: 33180415
DOI: 10.17116/sudmed20206306151 -
Der Pneumologe 2020This article describes viral, bacterial, fungal and parasitic infections, which are not endemic and little known in Germany. Avian influenza, Middle East respiratory...
This article describes viral, bacterial, fungal and parasitic infections, which are not endemic and little known in Germany. Avian influenza, Middle East respiratory syndrome (MERS) and the plague can all lead to severe pulmonary complications with a high mortality. In addition, there is a risk of nosocomial spread and therefore patients must always be isolated. Melioidosis, blastomycosis, paracoccidioidomycosis, and histoplasmosis are primarily often misclassified as community-acquired pneumonia due to typical causative organisms. A detailed anamnesis focussing on exposure in endemic areas is key to the diagnosis. Paragonimiasis is often manifested a few weeks after consumption of raw seafood and pronounced eosinophilia is typical. Relevant aspects of the epidemiology, clinical course, treatment and, if applicable, prevention are presented as cases of these diseases can occur at any time in Germany.
PubMed: 33162874
DOI: 10.1007/s10405-020-00352-3 -
Parasitology Research Dec 2020As a result of the experimental infection of rats with metacercariae of Paragonimus heterotremus Chen et Hsia, 1964 from crabs (Potamiscus tannanti) caught in Yen Bai...
As a result of the experimental infection of rats with metacercariae of Paragonimus heterotremus Chen et Hsia, 1964 from crabs (Potamiscus tannanti) caught in Yen Bai province, Vietnam, it was found that worms migrated into the lungs, to the liver and less frequently to the tissue that lines body cavities of the hosts, where they reached the adult stage, but in the muscles, worms stayed at the larval stage. Studies have shown that for P. heterotremus, rats can simultaneously play the role of the final and paratenic host; herewith, an infection with the trematode of this species can lead to the development of three forms of paragonimiasis: pulmonary, hepatic and muscular. Eggs from the adult worms localised in the liver, unlike eggs from the adult worms localised in the lungs, were not excreted into the external environment, but accumulated inside the organ. Histology and description of changes, which take place on the external surface of organs affected with P. heterotremus, are given in this study. Based on the behavioural characteristics of worms during rat infection and molecular genetic data, we established that worms from Vietnam and India should be assigned to different species of Paragonimus. P. heterotremus distribution is limited to the territory of the Southeast China, Northern Vietnam, Laos and Thailand.
Topics: Animals; Brachyura; China; India; Laos; Liver; Lung; Metacercariae; Muscles; Paragonimiasis; Paragonimus; Rats; Thailand; Vietnam
PubMed: 33068148
DOI: 10.1007/s00436-020-06929-4