Case Of Pulmonary Paragonimiasis Research Articles

Identification of pulmonary paragonimiasis using Ziehl-Neelsen stain

Pulmonary paragonimiasis and tuberculosis are endemic in Asia, South America, and Africa. However, differential diagnosis among the diseases is difficult because they present with similar clinical symptoms and diagnostic features. Here, we report a case of pulmo nary paragonimiasis that was identified using Ziehl-Neelsen stain after initially being assessed for pulmonary tuberculosis. Following anti-Paragonimus chemotherapy, the patient’s symptoms, laboratory test results, and lung lesions improved. Thus, the identification of Paragonimus westermani using Ziehl-Neelsen stain can be considered in the diagnosis. (Allergy Asthma Respir Dis 2020;8:36-39)

Paragonimus westermani infection in lung: A confounding diagnostic entity.

Paragonimiasis is a food-borne parasitic zoonosis caused by the genus Paragonimus. Fresh water snails, crabs, and crayfish are the first and second intermediate hosts, respectively. Humans acquire this infection by ingesting uncooked/undercooked crustaceans. Laboratory diagnosis of Paragonimiasis is done by demonstration of ova in the sputum/feces/pleural fluid or by serology. A case of pulmonary Paragonimiasis is presented herewith; the patient having been diagnosed with pulmonary tuberculosis earlier. The aim of this presentation is to highlight this entity so that it is considered in the differential diagnosis in a case of hemoptysis.

A Case of Pulmonary Paragonimiasis with Involvement of the Abdominal Muscle in a 9-Year-Old Girl

In Korea, many people enjoy eating raw or underkooked freshwater crayfish and crabs which unfortunately may cause paragonimiasis. Here, we describe a case of pulmonary and abdominal paragonimiasis in a 9-year-old girl, who presented with a 1-month history of abdominal pain, especially in the right flank and the right inguinal area, with anorexia. A chest radiograph revealed pleural effusion in both lungs, and her abdominal sonography indicated an inflammatory lesion in the right psoas muscle. Peripheral blood analysis of the patient showed hypereosinophilia (66.0%) and an elevated total serum IgE level (>2,500 IU/ml). The pleural effusion tested by ELISA were also positive for antibodies against paragonimiasis. Her dietary history stated that she had ingested raw freshwater crab, 4 months previously. The diagnosis was pulmonary paragonimiasis accompanied by abdominal muscle involvement. She was improved after 5 cycles of praziquantel treatment and 2 times of pleural effusion drainage. In conclusion, herein, we report a case of pulmonary and abdominal paragonimiasis in a girl who presented with abdominal pain and tenderness in the inguinal area.

A Case of Pulmonary Paragonimiasis with Recurrent Pleural Effusion and Cured by Four Cycles of Chemotherapy

폐흡충증은 예전에 비해서 발생 빈도가 감소 하였으나, 현재도 산발적으로 발생하고 있다. 폐흡충증은 민물 게나 민물 가재 등의 섭취력이 있고, 혈액검사상 호산구 증가증이 있는 경우 의심을 해보아야 한다. 객담이나 대변 검사상 충란을 발견할 경우 폐흡충증을 진단할 수 있으나 실제로 발견되는 경우는 40% 미만이므로 폐흡충증이 의심된다면 방사선학적 및 혈청학적 방법에 의해 폐흡충증을 확인하는 것이 필요하다. 치료로는 praziquantel 25 mg/kg씩 1일 3회, 이틀간 투여하는 1회 치료 과정으로 비교적 좋은 예후를 보인다. 그러나 본 증례처럼 1회 치료로 불충분하여 재발하는 경우가 있으므로 치료 후에도 정기적인 추적 관찰이 필요하겠다. 또한 재발 및 재치료율을 낮추기 위한 연구와 재발 환자의 치료 기간 정립이 필요할 것으로 생각된다. 저자들은 좌측 흉수를 주소로 내원하여 폐흡충에 의한 흉수로 진단 받은 35세 환자에서 praziquantel25 mg/kg씩 1일 3회, 2일간 투여하여 호전 보였으나, 이후에 3차례나 재발하여 총 4차례 치료 과정을 반복하여 호전된 증례를 경험하였기에 문헌과 함께 보고하는 바이다.

A Case of Pulmonary Paragonimiasis Presented as Solitary Pulmonary Nodule and Suspected as Lung Cancer on 18F-Fluorodeoxyglucose Positron Emission Tomography

Pulmonary paragonimiasis continues to be a diagnostically challenging parasitic disease, despite a drastically decreased prevalence in South Korea during the past decade. Pulmonary paragonimiasis is characterized by fever, chest pain, and chronic cough with hemoptysis. Numerous radiographic and computed tomographic findings including the presence of pneumothorax, pleural effusion, and parenchymal lesions such as nodular or infiltrative opacities have been reported. The clinical and radiological manifestations of paragonimiasis can resemble those of lung cancer, tuberculosis or a metastatic malignancy. Furthermore, this disease can mimic lung cancer as seen on -fluorodeoxyglucose positron emission tomography (FDG-PET). We report a case of pulmonary paragonimiasis in a 48-year old man that presented with a solitary pulmonary nodule and was suspected as a lung cancer based on FDG-PET imaging.

Two cases of pulmonary paragonimiasis on FDG-PET CT imaging

Positron emission tomography (PET) using 18F-fluorodeoxyglucose (FDG) is useful in cancer diagnosis owing to its sensitivity to the differences in glucose metabolic rate between benign and malignant diseases, especially in the lung. One pitfall in PET imaging of lung disease, however, is the overlap in metabolic rate of inflammatory and neoplastic entities. Paragonimiasis is a food-borne parasitic disease that causes the pulmonary and pleural inflammation. We present two cases of pulmonary paragonimiasis that showed high uptake suggestive of tumor on FDG-PET CT images, both confirmed on histopathology by visualization of Paragonimus westermani eggs in the involved tissues.

Three Cases of Pulmonary Paragonimiasis in a Family after Ingestion of Raw Fresh-water Crayfishes caught in a Stream of Wolchulmountain

Three Cases of Pulmonary Paragonimiasis in a Family after Ingestion of Raw Fresh-water Crayfishes caught in a Stream of Wolchulmountain

BITHIONOL THERAPY FOR LUNG PARAGONIMIASIS

Bithionol is a new drug which has shown good effect in paragonimiasis. The authors treated 36 cases of pulmonary paragonimiasis from June 1962 to June 1963. In all cases eggs of paragonimus westermani were found in sputum before treatment. The most characteristic symptoms; bloody sputum or frank hemoptysis, which was seen in 33 of 36 cases, disappeared completely in 10 of 14 cases especially closely checked to that effect. Laboratory findings such as leukocyte did not show significant change under Bithionol treatment, but sedimentation rate improved in about 1/2 of the cases, liver function tests did not show any change under Bithionol treatment. Of side reaction under Bithionol treatment gastrointestinal symptoms such as diarrhea, loose stools or frequent defecation was seen in 10 cases(27.7%) skin manifestations such as urticaria and itching in 7(18.4%). All the side reactions subsided when medication was continued every other day. In no case we were forced to stop medication.