Abstract
ObjectiveTo summarize the clinical characteristics of adult cases of paragonimiasis with lung masses as the main manifestation in Xishuangbanna, Yunnan Province, analyze the causes of misdiagnosis, and improve the levels of clinical diagnosis and treatment.MethodWe conducted a retrospective analysis of the clinical data and diagnosis and treatment of 8 adult cases of paragonimiasis with lung masses as the main manifestation that were diagnosed in the Oncology Department of People’s hospital of Xishuangbanna Dai Autonomous Prefecture from July 2014 to July 2019.ResultAll 8 patients were from epidemic paragonimiasis areas and had a confirmed history of consuming uncooked freshwater crabs. The clinical manifestations were mainly fever, dry cough, and chest pain. The disease durations were long, and peripheral blood eosinophil counts were elevated. The cases had been misdiagnosed as pneumonia or pulmonary tuberculosis. After years of anti-inflammatory or anti-tuberculosis treatment, the symptoms had not improved significantly. Patients eventually sought treatment from the oncology department for hemoptysis. Chest computed tomography showed patchy consolidation in the lungs, with nodules, lung masses, and enlarged mediastinal lymph nodes.ConclusionParagonimiasis is a food-borne parasitic disease. Early clinical manifestations and auxiliary examination results are nonspecific. The parasite most often invades the lungs, and the resulting disease is often misdiagnosed as pneumonia, pulmonary tuberculosis, or lung cancer (Acta Trop 199: 05074, 2019). To avoid misdiagnosis, clinicians should inquire, in detail, about residence history and history of unclean food and exposure to infected water and make an early diagnosis based on the inquired information and imaging examination results. For patients who have been diagnosed with pneumonia or pulmonary tuberculosis and whose symptoms do not improve significantly after anti-inflammatory or anti-tuberculosis treatments, their epidemiological history should be traced to further conduct differential diagnosis and avoid misdiagnosis.
Highlights
Paragonimiasis is a systemic chronic parasitic disease caused by Paragonimus infection
The parasite most often invades the lungs, and the resulting disease is often misdiagnosed as pneumonia, pulmonary tuberculosis, or lung cancer (Acta Trop 199: 05074, 2019)
Clinicians should inquire, in detail, about residence history and history of unclean food and exposure to infected water and make an early diagnosis based on the inquired information and imaging examination results
Summary
Paragonimiasis is a systemic chronic parasitic disease caused by Paragonimus infection. It is a natural focal disease and one of the food-borne parasitic diseases that cause great harm to both humans and animals [1]. Medical staff have insufficient knowledge of the disease, and the misdiagnosis rate is high. Paragonimiasis in adults is often misdiagnosed as pneumonia, pulmonary tuberculosis, or even lung cancer [3]. We summarize the clinical manifestations and causes of misdiagnosis of 8 adult cases of paragonimiasis with lung masses as the main manifestation in People’s hospital of Xishuangbanna Dai Autonomous Prefecture in the past 5 years, so as to improve the understanding of the disease among medical professionals and reduce the misdiagnosis rate
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