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The American Journal of Tropical... Sep 2020
Topics: Animals; Anthelmintics; Brachyura; Bronchoalveolar Lavage Fluid; Cambodia; Cough; Female; Humans; Japan; Lung Diseases, Parasitic; Middle Aged; Paragonimiasis; Paragonimus; Praziquantel; Travel
PubMed: 32896236
DOI: 10.4269/ajtmh.20-0395 -
GigaScience Jul 2020Paragonimus spp. (lung flukes) are among the most injurious foodborne helminths, infecting ∼23 million people and subjecting ∼292 million to infection risk....
BACKGROUND
Paragonimus spp. (lung flukes) are among the most injurious foodborne helminths, infecting ∼23 million people and subjecting ∼292 million to infection risk. Paragonimiasis is acquired from infected undercooked crustaceans and primarily affects the lungs but often causes lesions elsewhere including the brain. The disease is easily mistaken for tuberculosis owing to similar pulmonary symptoms, and accordingly, diagnostics are in demand.
RESULTS
We assembled, annotated, and compared draft genomes of 4 prevalent and distinct Paragonimus species: Paragonimus miyazakii, Paragonimus westermani, Paragonimus kellicotti, and Paragonimus heterotremus. Genomes ranged from 697 to 923 Mb, included 12,072-12,853 genes, and were 71.6-90.1% complete according to BUSCO. Orthologous group analysis spanning 21 species (lung, liver, and blood flukes, additional platyhelminths, and hosts) provided insights into lung fluke biology. We identified 256 lung fluke-specific and conserved orthologous groups with consistent transcriptional adult-stage Paragonimus expression profiles and enriched for iron acquisition, immune modulation, and other parasite functions. Previously identified Paragonimus diagnostic antigens were matched to genes, providing an opportunity to optimize and ensure pan-Paragonimus reactivity for diagnostic assays.
CONCLUSIONS
This report provides advances in molecular understanding of Paragonimus and underpins future studies into the biology, evolution, and pathogenesis of Paragonimus and related foodborne flukes. We anticipate that these novel genomic and transcriptomic resources will be invaluable for future lung fluke research.
Topics: Animals; Computational Biology; Disease Susceptibility; Gene Expression Profiling; Gene Ontology; Genomics; Host-Parasite Interactions; Humans; Molecular Sequence Annotation; Multigene Family; Paragonimiasis; Paragonimus; Phylogeny; Transcriptome
PubMed: 32687148
DOI: 10.1093/gigascience/giaa073 -
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 -
Pathogens and Global Health May 2020Improving paragonimiasis surveillance, which is crucial for disease control, requires adopting new tools and techniques useful in mapping endemic areas. This study aimed...
Identification of suspected paragonimiasis-endemic foci using a questionnaire and detection of ova using the Ziehl-Neelsen technique in Zamboanga Region, the Philippines.
Improving paragonimiasis surveillance, which is crucial for disease control, requires adopting new tools and techniques useful in mapping endemic areas. This study aimed to (1) develop a questionnaire to identify suspected paragonimiasis-endemic foci, (2) describe the epidemiology of paragonimiasis, and (3) evaluate Ziehl-Nielsen Staining technique (ZNS) in detecting ova. The questionnaire, which municipal health officers filled out, was based on proposed site inclusion criteria utilized in the integrated tuberculosis (TB)-paragonimiasis surveillance and control project. Newly deployed medical technologists in Zamboanga Region underwent training, which included laboratory diagnosis of paragonimiasis using preserved and fresh specimens and an integrated tuberculosis-paragonimiasis survey in nine selected (villages). Paragonimiasis cases were found in seven out of the nine barangays identified by the questionnaire. Of the 373 patients, three (0.80%) were TB-positive, and 29 (7.77%) were paragonimiasis-positive. The highest paragonimiasis prevalence (27%) was found in Barangay Libato. Ziehl-Neelsen Staining technique (ZNS) correctly detected 8 out of the 29 samples positive (sensitivity - 27.59%; 95% CI: 12.73-47.24%) and all the 334 samples negative (specificity - 100%; 95% CI: 98.90-100%) for ova. The questionnaire may be improved by refining the inclusion criteria. In paragonimiasis-endemic areas, the ZNS and the NaOH concentration technique may be used for detecting ova. Modifying the ZNS, for instance by including a concentration step, may improve its sensitivity. The model for the integrated capacity building of health workers and surveillance and research demonstrated in this project may contribute to improving surveillance and control of paragonimiasis and other neglected tropical diseases.
Topics: Adolescent; Adult; Animals; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Middle Aged; Paragonimiasis; Paragonimus; Parasite Egg Count; Philippines; Surveys and Questionnaires; Young Adult
PubMed: 32191613
DOI: 10.1080/20477724.2020.1741900 -
The Korean Journal of Parasitology Feb 2020During the mobile clinic activities in Tak Province, Thailand, Paragonimus sp. eggs were found in a fecal sample of a 72-year-old Karen resident. Paragonimus DNA was...
During the mobile clinic activities in Tak Province, Thailand, Paragonimus sp. eggs were found in a fecal sample of a 72-year-old Karen resident. Paragonimus DNA was amplified from the stool sample and identified to P. heterotremus. The patient did not have any symptoms. Apparent pulmonary lesion was not found on the chest X-ray. The patient admitted habitual consumption of semi-cooked or roasted waterfall crabs for several years. The waterfall crabs collected from stream near the village were found negative for Paragonimus metacercariae. In northern Thailand, paragonimiasis remains as one of the public health concerns and should be ruled out for asymptomatic pulmonary patients.
Topics: Aged; Animals; Asian People; Asymptomatic Infections; Feces; Humans; Male; Paragonimiasis; Paragonimus; Thailand
PubMed: 32145728
DOI: 10.3347/kjp.2020.58.1.57 -
Parasites & Vectors Feb 2020Trichinella spiralis muscle larval (ML) excretion/secretion (ES) antigen is the most widely used diagnostic antigen of trichinellosis, but preparation of ES antigen...
BACKGROUND
Trichinella spiralis muscle larval (ML) excretion/secretion (ES) antigen is the most widely used diagnostic antigen of trichinellosis, but preparation of ES antigen requires collecting worms from infected animals, and detection of specific IgG against ML ES antigen may result in a false negative at the early stage of infection. The aim of the study was to characterize T. spiralis elastase-1 (TsEla) and to evaluate its potential as diagnostic antigen for trichinellosis.
METHODS
The complete cDNA sequences of the TsEla gene were cloned and expressed, and recombinant (rTsEla) was purified. TsEla transcription and expression in different T. spiralis life-cycle stages was investigated by qPCR and western blotting, and its location in the nematodes was evaluated using an immunofluorescence assay (IFA). The antigenicity of rTsEla was investigated by western blotting analysis and ELISA. Anti-Trichinella IgG, IgM and IgE of experimentally infected mice and specific IgG antibodies of trichinellosis patients were assayed by rTsEla-ELISA and ES-ELISA.
RESULTS
The results of the qPCR and western blotting showed that TsEla was expressed in various T. spiralis life stages. Natural TsEla was detected in the soluble proteins and ES proteins of different life stages. IFA revealed that TsEla was identified in the whole nematodes of various stages, especially in the cuticle, stichosome and genital primordium of the parasite. Serum anti-Trichinella IgM, IgG and IgE in infected mice was first detected by rTsEla-ELISA at 6, 10 and 12 days post-infection (dpi), and reached 100% at 8, 14 and 14 dpi, respectively. When rTsEla-ELISA and ES-ELISA were used to detect anti-Trichinella IgG in sera of trichinellosis patients, the sensitivity was 97.37% (37/38) and 89.74% (34/38) (P > 0.05), and the specificity was 99.10% (220/222) and 98.20% (218/222), respectively (P > 0.05). The rTsEla cross-reacted with only one serum sample out of 20 samples from paragonimiasis patients and 7 samples from clonorchiasis patients.
CONCLUSIONS
rTsEla is valuable to early diagnosis of trichinellosis and could be an alternative diagnostic antigen to the ML ES antigens.
Topics: Amino Acid Sequence; Animals; Antibodies, Helminth; Antigens, Helminth; Blotting, Western; Enzyme-Linked Immunosorbent Assay; Female; Helminth Proteins; Humans; Life Cycle Stages; Mice, Inbred BALB C; Pancreatic Elastase; Sequence Alignment; Trichinella spiralis; Trichinellosis
PubMed: 32093735
DOI: 10.1186/s13071-020-3981-y -
The Korean Journal of Parasitology Dec 2019Horace N. Allen, an American physician, was a Presbyterian missionary to Korea. In 1886, he wrote the annual report of the Korean government hospital, summarizing...
Horace N. Allen, an American physician, was a Presbyterian missionary to Korea. In 1886, he wrote the annual report of the Korean government hospital, summarizing patient statistics according to outpatient and inpatient classification for the first ever in Korean history. In the report, he speculated that hemoptysis cases of outpatient might have been mainly caused by distoma. Allen's conjecture was noteworthy because only a few years lapsed since the first scientific report of paragonimiasis. However, he was not sure of his assumption either because it was not evidently supported by proper microscopic or post-mortem examinations. In this letter, we thus revisit his assumption with our parasitological data recently obtained from Joseon period mummies.
Topics: Animals; Archaeology; Autopsy; Helminthiasis; Helminths; Hemoptysis; History, 18th Century; History, 19th Century; Humans; Mummies; Ovum; Parasitology; Prevalence; Republic of Korea
PubMed: 31914516
DOI: 10.3347/kjp.2019.57.6.635 -
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 -
Archivos Argentinos de Pediatria Dec 2019Paragonimiasis is a parasite infection caused by several species of Paragonimus, a trematode that is transmitted through the consumption of raw or undercooked crabs and...
Paragonimiasis is a parasite infection caused by several species of Paragonimus, a trematode that is transmitted through the consumption of raw or undercooked crabs and that has been found in the subtropical areas of America, Asia and Africa. This infection mainly affects the lungs, causing clinical and radiological manifestations very similar to pulmonary tuberculosis, so it should always be included in the differential diagnosis. We present the case of a 7-year-old school patient, hospitalized with the diagnosis of pulmonary paragonimiasis, who had a favorable evolution after receiving treatment with triclabendazole.
Topics: Animals; Antiplatyhelmintic Agents; Child; Female; Humans; Lung Diseases, Parasitic; Paragonimiasis; Paragonimus; Triclabendazole
PubMed: 31758906
DOI: 10.5546/aap.2019.e659 -
AJNR. American Journal of Neuroradiology Dec 2019Intraspinal paragonimiasis is a rare entity for which imaging findings have seldom been described. The present study investigated the MR imaging features of spinal...
BACKGROUND AND PURPOSE
Intraspinal paragonimiasis is a rare entity for which imaging findings have seldom been described. The present study investigated the MR imaging features of spinal paragonimiasis, thus providing diagnostic imaging evidence and exploring the possible pathogenesis of intraspinal paragonimiasis.
MATERIALS AND METHODS
The clinical and imaging findings of spinal paragonimiasis in 6 children were analyzed retrospectively. Spinal MR imaging was performed in all patients, 5 of whom also underwent enhanced MR imaging. The diagnosis was confirmed by enzyme-linked immunosorbent assay in all cases and postoperative pathology in 4 cases.
RESULTS
All cases manifested as fusiform-shaped or beanlike masses in the extradural space in the thoracic spine. The extradural masses were connected with pleural lesions through the intervertebral foramen. The plain MR imaging scan showed mixed signals with predominant isointensity on T1WI and hyperintensity on T2WI, among which 5 (5/6) masses presented as patchy hemorrhage with hyperintensity on T1WI. On enhanced scans, all masses (5/5) showed heterogeneous marked enhancement, with thickening and enhancement in the adjacent spinal meninges (5/5). Various degrees of spinal cord compression and edema were found in 5 cases (5/6).
CONCLUSIONS
MR imaging is sensitive for detecting and characterizing spinal paragonimiasis. The MR imaging features of intraspinal granulomas included localization to the extradural space and thoracic segment, connections between intraspinal lesions and pleural lesions through the intervertebral foramen, and hemorrhagic foci within the mass. These findings support an intraspinal mode of paragonimiasis pathogenesis: The larvae migrate from the chest into the extradural space through the intervertebral foramen.
Topics: Child; Female; Granuloma; Humans; Magnetic Resonance Imaging; Male; Paragonimiasis; Retrospective Studies; Spinal Diseases; Tomography, X-Ray Computed
PubMed: 31727748
DOI: 10.3174/ajnr.A6296