Unresolving Pneumonia with Pleural effusion: Pulmonary Paragonimiasis

Deepshikha Gaire,Kumar Poudel,Pankaj Pant,Santosh Sharma

doi:10.31729/jnma.3154

Abstract

Paragonimiasis is a zoonosis caused by many species of Paragonimus commonly P. westermani. Human get infected by eating raw, salted, pickled, smoked, partially cooked crustaceans (crayfish or crabs). Clinical manifestations ranges from non-specific symptoms like pain abdomen, diarrhea, urticarial rashes, fever to pleuropulmonary symptoms like cough, hemoptysis, chest pain and dyspnea. A 48 years, female presented at TUTH emergency with fever on and off for nine months, cough and shortness of breath for three months, lethargy, malaise and urticaria with history of raw crab intake one month prior to the onset of symptoms. Blood and pleural fluid analysis revealed raised total counts with eosinophilia and x-ray showed bilateral infiltration of lower lobes with pleural effusion. Diagnosis was confirmed by microscopic examination of sputum for Paragonimus. She responded well to Praziquantel. Pulmonary paragonimiasis must be considered in the differential diagnosis of unresolving pneumonia and unexplained hypereosinophilia.

Highlights

Paragonimiasis is a food-borne zoonotic disease caused by number of species of trematodes, Paragonimus commonly with P. westermani
The life cycle of Paragonimus get completed in snailcrustaceans-human host
Human being get infected by eating uncooked, undercooked, pickled, marinated crayfish or crabs, which posses viable metacercarciae of Paragonimus

Summary

INTRODUCTION

Paragonimiasis is a food-borne zoonotic disease caused by number of species of trematodes, Paragonimus commonly with P. westermani. Gaire et al Unresolving Pneumonia with Pleural effusion: Pulmonary Paragonimiasis month prior to the onset of symptoms With all these history she came to our center. On the background of history of intake of raw crabs, with symptoms of fever and cough, eosinophilia on investigation and ova of paragonimus seen in microscopic examination of sputum, diagnosis was confirmed as pulmonary paragonimiasis. She was treated with 25mg/kg of Praziquantel three times a day for 3 days, responded well to treatment and was recovered fully on subsequent follow up

DISCUSSION

Findings

Cabrera BD: Paragonimiasis in the Philippines