Enzyme-linked immunosorbent assay (ELISA) and immunoblot serologic tests are also available and can point to the diagnosis (35). Mukae H, Taniguchi H, Matsumoto N, Iiboshi H, Ashitani J, Matsukura S, Nawa Y. Clinicoradiologic features of pleuropulmonary Paragonimus westermani on Kyusyu Island, Japan. However, paragonimiasis should always be ruled out in individuals from endemic areas who present with hemoptysis and negative diagnostic tests for pulmonary tuberculosis.
Arzneimittelforschung. [PubMed], 3. AJR American Journal of Roentgenology 2005;185:616-621. Urol Int. [PubMed], 27.
Cerebral Paragonimiasis: An unusual manifestation of a rare parasitic infection. Several species have been reported in humans, including species of the Paragonimus westermani and P. skrjabini complex, P. africanus, P. caliensis, P. heterotremus, P. hueitungensis, >P. Paragonimiasis: diagnosis and the use of praziquantel in treatment. Moreover, raw juice and meat of crab or crayfish is used in traditional medicine treating measles and episodes of fever and diarrhea. In light infections, most individuals are asymptomatic. Kim TS, Han J, Shim SS, Jeon K, Koh WJ, Lee I, Lee, K. S., and Kwon, O. J. Pleuropulmonary paragonimiasis: CT findings in 31 patients. Hamajima F, Fujino T, Yamagami K, Eriguchi N. Studies on the in vitro effects of bithionol and menichlopholan on flukes of Clonorchis sinensis, Metagonimus takahashii and Paragonimus miyazakii. Linear areas of increased opacity or hyperattenuation indicate peripheral atelectasis or worm migration. padding: 0; Moreover, it should be noted that ~20% of Paragonimus infections are asymptomatic. Most cases have negative seroconversion 6 months after treatment. No recent in vitro and in vivo chemotherapeutic studies have been carried out with Paragonimus spp. [PubMed], 51. In the late 1970s and early 1980s bithionol, menichlopholan, and the current drug of choice praziquantel were studied against P. westermani, P. ohirai, and P. miyazakii (13, 28, 51). 33. Advances in Parasitology 2010;72: 351-408. However, chest radiography findings may be normal in 12.8% to 20% of patients with confirmed paragonimiasis (38). Preventive chemotherapy in human helminthiasis: coordinated use of anthelminthic drugs in control interventions: a manual for health professionals and programme managers. Images in clinical medicine. The link was not copied. 2012;366:165. of the brain) or feces; but requires well-trained microscopists (4). A review. kellicotti is the only species native to North America, P. caliensis and P. mexicanus occur in Central and South America and P. africanus and P. uterobilateralis have been described from West Africa.
PLoS One 9(3): e92034. due to Balamuthia mandrillaris, Naegleria spp.). occurs through the ingestion of raw or insufficiently cooked freshwater crabs or crayfish infected with metacercariae. may also be prevalent in wild feline reservoir hosts or in household pets (mainly cats and dogs). Triclabendazole has been shown to have a better clinical tolerance, a more rapid parasitologic response, and comparable resolution of clinical symptoms when compared to treatment with praziquantel (6). More than 23 million people are infected, causing a global burden of 196,710 disability-adjusted life years (DALYs) (12). [PubMed], 50. cycle flukes intestinal parasites pathophysiology miracidium International Journal for Parasitology 1979;9: 241-249. Control of foodborne trematode infections. Clinical Microbiology Reviews 2009;22:466-483. AJR American Journal of Roentgenology 1992;159:39-43. Once mature flukes have inhabited the lung (in the absence of treatment, this stage of infection may persist for 20 years in humans), the most common complaint is recurrent hemoptysis with chocolate-colored sputum (which is a mixture of blood, inflammatory cells, and Paragonimus eggs) and a chronic cough. 2009;103:1019-23 [PubMed], 44. Clinical features of recently diagnosed pulmonary paragonimiasis in Korea. .item01 {
After a complex process of multiplication and different developmental steps, cercariae are released, which infect the second intermediate crustacean hosts (5, 34). Odermatt P, Nanthaphone S, Barennes H, Chanthavysouk K, Tran DS, Kosanouvong B, Keola S, Mathouchanh P, Choumlivong K, Keoluangkhot V, Phoumindr N, Nanthanavone S, Phrommala S, Degremont A, Strobel M. Improving tuberculosis case detection rate with a lay informant questionnaire: an experience from the Lao People's Democratic Republic.
Lung radiology in the tropics. Transbronchial biopsies may also confirm the diagnosis. [PubMed], 21. Lancet Infect Dis. Prominent leukocytosis with eosinophilia occurs during early pulmonary parenchymal involvement but later resolves or is minimal. Unlike adjunctive treatment for neurocysticercosis in which corticosteroids are introduced to reduce mounting cerebral inflammation in response to cysticercus larva lysis after antiparasitic treatment, there are no convincing data to support the benefit of corticosteroids used as adjunctive therapy for cerebral paragonimiasis. width: 100%; [PubMed], 29. Treatment has been mainly by the use of emetine in two courses consisting of 1 grain (0.06 gram) daily by hypodermic injection for 7 days, with a period of 1 week's rest, then a repetition of the treatment. AJR American Journal of Roentgenology 1994;162:141-145. Lipiodol oil instillations in 6 cases failed to demonstrate any dilation of the bronchi or connection with cavities except in one instancethere were two small pools of oil in the upper right lobe. Keiser J, Utzinger J. and amebic encephalitis (e.g. Eosinophilic pneumonias. Johnson RJ, Jong EC, Dunning SB, Carberry WL, Minshew BH. It is rare for cerebral symptoms to occur without evidence of chest disease and, in the majority of cases (70%), pulmonary symptoms occur first (14).
Yokogawa M. Experimental chemotherapy of paragonimiasis. More advanced serological tests, which are currently being researched, include a colloidal gold immunochromatographic strip for detection of P. skrjabini infections (44), and protein microarray for the rapid, sensitive, and high-throughput diagnosis of disease specific antibodies of paragonimiasis and other helminth infections (10). background: #ddd; P. heterotremus, P. hueitungensis P. miyazakii, P. skrjabiniP. In many patients on a percussion of the chest, it is possible to demonstrate hyperresonance of varying degree, but the breath sounds are essentially normal. Handb Clin Neurol. The penetration of juvenile worms through the diaphragm into the pleural cavity can cause pleural effusion or pneumothorax. WHO Tech. American Journal of Tropical Medicine and Hygiene 1988;39:469-471. Slesak G, Inthalad S, Basy P, Keomanivong D, Phoutsavath O, Khampoui S, Grosrenaud A, Amstutz V, Barennes H, Buisson Y, Odermatt P. Ziehl-Neelsen staining technique can diagnose paragonimiasis. Praziquantel is a heterocyclic azoquinoline compound that is effective against pulmonary paragonimiasis and all forms of ectopic infections. Complications of cysts include pleural effusion, empyema, and pneumothorax (14, 15, 17, 29, 30, 42). kellicotti, P. mexicanus, P. miyazakii P. siamensis, and P. uterobilateralis (5, 21). [PubMed], 39. Mehlhorn H, Kojima S, Rim HJ, Ruenwongsa P, Andrews P, Thomas H, Bunnag B. Ultrastructural investigations on the effects of praziquantel on human trematodes from Asia: Clonorchis sinensis, Metagonimus yokogawai, Opisthorchis viverrini, Paragonimus westermani and Schistosoma japonicum. Lung flukes are hermaphroditic trematodes. 2013;114:283-96. Pediatr Neurol. Vanijanonta S, Bunnag D, Harinasuta T. Radiological findings in pulmonary paragonimiasis heterotremus. Food does not interfere with, but conversely enhances systemic absorption of triclabendazole. Parasite eggs, produced by the adult worms in the lungs of the final host, are released via sputum and / or feces. Ph.D., Once the parasites reach the lung, patchy airspace consolidation can occur, a phenomenon that reflects the presence of an exudative or hemorrhagic pneumonia which can cavitate. Cerebral Paragonimiasis: Central nervous system (CNS) involvement, caused by aberrant migration of juvenile flukes through the foramina of the skull (commonly via the jugular foramen) has been estimated to occur in 0.8% of all cases of paragonimiasis (8). Lipiodol oil instillations into the bronchi for diagnostic purposes seemed to give a measure of relief from the symptoms of cough, and in 1 case the patient stated that the bloody discharge was less. 1Pyengyang Union Christian Hospital, Korea. However, the effectiveness of this community intervention has not yet been documented. Sawanyawisuth K, Chotmongkol V. Eosinophilic meningitis. Praziquantel (25 mg/kg tid for 2 days) is the drug of choice for paragonimiasis (21, 46). Korean J Parasitol. Cerebrospinal fluid pleocytosis with high eosinophil count is common. Neuroradiology 1988;30:31-34. [PubMed], 13. Chen JX, Chen MX, Ai L, Chen JH, Chen SH, Zhang YN, Cai YC, Zhu XQ, Zhou XN. Other symptoms which have been recorded are: fever, chills, night sweats, shortness of breath, distress in the chest, loss of appetite, loss of weight, and indigestion. Once penetration of the diaphragm and migration into the pleural cavity has occurred (2 to 8 weeks postinfection), patients may have pleuritic chest pain, which is often bilateral. The ecologic requirements of the first and second intermediate hosts, in combination with the presence of the reservoir hosts and the widespread habit of the local population to consume raw or insufficiently cooked crab and crayfish govern the focal transmission of paragonimiasis and explain patchy distribution patterns of the disease (21). Bulletin of the World Health Organization 2007;85:727-731. J Neurosurg Pediatr 2015;15: 101-106. display: flex; The American Journal of Tropical Medicine and Hygiene, The Organization of the Viscerotome Service of the Brazilian Cooperative Yellow Fever Service, Effects of Protective Immune Serum on the Yields of Parasites and Pulmonary Cell Reactions in Schistosome-Infected Rats, Transactions of the American Society of Tropical Medicine, Thirty-First Annual Meeting, https://doi.org/10.4269/ajtmh.1937.s1-17.101, Click here to view the full Terms and Conditions. Diagnostic dilemmas in helminthology: what tools to use and when? Human Paragonimus spp. Wany Y, Wang L, Zhang J, Wang G, Chen W, Chen L, Zhang X. Severe pleuropulmonary paragonimiasis 8 years after emigration from a region of endemicity. 2012;6;e1899. (1985). Bergquist R, Johansen MV, Utzinger J. [PubMed], 38. [PubMed], 7. Therefore, paragonimiasis should always be included in the differential diagnosis for patients having lung lesions associated with eosinophilia and/or elevated serum IgE level, especially for those living in endemic areas. Geneva, World Health Organization. Clinics in Chest Medicine 2002;23:421-431. A massive influx of Ca2+ results in muscle contraction, which occurs within 10-20 seconds and leads to spastic paralysis of the flukes. [PubMed], 15. [PubMed]. Clinics in Chest Medicine 2002;23:409-420. Frst T, Keiser J, Utzinger J. [PubMed], 14. Pulmonary Paragonimiasis: Clinical manifestations depend on the stage of infection. Fried (ed. Johnson RJ, Johnson JR. Paragonimiasis in Indochinese refugees. Within the lung, which is the main habitat of adult Paragonimus flukes, the parasites form areas of inflammation surrounded by eosinophils, neutrophils, and later mononuclear leukocytes. Most of these patients under times of stress and strain, fatigue, or other unfavorable conditions, again develop blood-tinged sputum in the morning, and the ova again make their appearance, even after a lapse of several years. Clinical and radiographic findings may resemble those of lung cancer (having high fluorodeoxyglucose uptake on positron emission tomography (PET) with 18-fluorodeoxyglucose) (16, 22, 45), tuberculosis 16 mesothelioma, or metastatic malignancy (27). margin: 0; Singh TN, Kananbala S, Devi KS.
Trends in Parasitology 2009;25:151-156. Parasite egg detection rates in sputum or bronchoscopic aspirates are about 50% (39) and 24-hour sputum collection enhances the sensitivity of egg detection. As pulmonary parenchymal involvement occurs, leukocytosis and prominent blood eosinophilia are commonly seen. The unspecificity of some of these symptoms renders differential diagnosis difficult. 849. Trans R Soc Trop Med Hyg.
It is important to note that Ziehl-Neelsen staining or modified acid-fast staining techniques (e.g., Kinyoun stain), that are commonly employed for the microscopic diagnosis of pulmonary tuberculosis, also have a high sensitivity for detection of Paragonimus eggs in sputum samples (36). Clinical Microbiology Reviews Clin Microbiol Rev. The true extent of animal reservoir hosts for human infection is not known. J Vet Diagn Invest. [PubMed], 4. The global burden of human food-borne trematodiasis: a systematic review and meta-analysis. Within this fibrous capsule, the flukes mature and begin egg production, typically 8 weeks post infection. Handb Clin Neurol. CT findings of cerebral paragonimiasis in the chronic state. 2014;109:849-55. [PubMed], 18. 2011;5:e1048. N Engl J Med. hematologic malignancies) (32). Ann Afr Med. Migratory Subcutaneous Paragonimiasis: Migratory subcutaneous nodules occur in 10% of cases with paragonimiasis. ), Food-borne parasitic zoonoses.
Paragonimiasis acquired in the United States: native and nonnative species. Contrast material-enhanced computer tomography (CT) performed during this stage may show hypoattenuating fluid-filled cysts (5-15 mm) surrounded by hyperattenuating consolidation in the adjacent lung. [PubMed], 2. From experience to date, the instillation of oil seems to be well tolerated, but its therapeutic value can be determined only after extensive clinical trial with control observations. [PubMed], 45. Intradermal skin tests have been utilized for epidemiologic surveys but are no longer popular since novel techniques have become available (5). [PubMed], 49. 1984;34:1193-6. The American Review of Respiratory Disease 1983;128:534-538. More than 50 species have been described (9). The differential diagnosis includes among others: bronchiectasis, tuberculosis, penumonia, mitral stenosis, myocarditis, pleurisy with or without effusion, lung absecess, amebic abscess of the lung, infestations of the lung due to the presence of the larvae of ascaris, bilharzia, or filaria. Pleural effusions are exudative and laden with eosinophils. 2013;25:620-6. 2010;107:1391-7. 2013;26:493-504. Diaz JH. Likewise, a positive serology does not definitely diagnose infection with the P. westermani species; rather, it confirms infection with one of many Paragonimus species (5). 5. In the People's Republic of China, marinated crabs are consumed to relieve back pain. Pleuropulmonary paragonimiasis: radiologic findings in 71 patients. The habit of eating freshwater crab or crayfish raw or inadequately cooked is the key risk factor of acquiring a Paragonimus infection. parasitology taenia solium echinococcus infective saginata 
Arzneimittelforschung. [PubMed], 3. AJR American Journal of Roentgenology 2005;185:616-621. Urol Int. [PubMed], 27.
Cerebral Paragonimiasis: An unusual manifestation of a rare parasitic infection. Several species have been reported in humans, including species of the Paragonimus westermani and P. skrjabini complex, P. africanus, P. caliensis, P. heterotremus, P. hueitungensis, >P. Paragonimiasis: diagnosis and the use of praziquantel in treatment. Moreover, raw juice and meat of crab or crayfish is used in traditional medicine treating measles and episodes of fever and diarrhea. In light infections, most individuals are asymptomatic. Kim TS, Han J, Shim SS, Jeon K, Koh WJ, Lee I, Lee, K. S., and Kwon, O. J. Pleuropulmonary paragonimiasis: CT findings in 31 patients. Hamajima F, Fujino T, Yamagami K, Eriguchi N. Studies on the in vitro effects of bithionol and menichlopholan on flukes of Clonorchis sinensis, Metagonimus takahashii and Paragonimus miyazakii. Linear areas of increased opacity or hyperattenuation indicate peripheral atelectasis or worm migration. padding: 0; Moreover, it should be noted that ~20% of Paragonimus infections are asymptomatic. Most cases have negative seroconversion 6 months after treatment. No recent in vitro and in vivo chemotherapeutic studies have been carried out with Paragonimus spp. [PubMed], 51. In the late 1970s and early 1980s bithionol, menichlopholan, and the current drug of choice praziquantel were studied against P. westermani, P. ohirai, and P. miyazakii (13, 28, 51). 33. Advances in Parasitology 2010;72: 351-408. However, chest radiography findings may be normal in 12.8% to 20% of patients with confirmed paragonimiasis (38). Preventive chemotherapy in human helminthiasis: coordinated use of anthelminthic drugs in control interventions: a manual for health professionals and programme managers. Images in clinical medicine. The link was not copied. 2012;366:165. of the brain) or feces; but requires well-trained microscopists (4). A review. kellicotti is the only species native to North America, P. caliensis and P. mexicanus occur in Central and South America and P. africanus and P. uterobilateralis have been described from West Africa.
PLoS One 9(3): e92034. due to Balamuthia mandrillaris, Naegleria spp.). occurs through the ingestion of raw or insufficiently cooked freshwater crabs or crayfish infected with metacercariae. may also be prevalent in wild feline reservoir hosts or in household pets (mainly cats and dogs). Triclabendazole has been shown to have a better clinical tolerance, a more rapid parasitologic response, and comparable resolution of clinical symptoms when compared to treatment with praziquantel (6). More than 23 million people are infected, causing a global burden of 196,710 disability-adjusted life years (DALYs) (12). [PubMed], 50. cycle flukes intestinal parasites pathophysiology miracidium International Journal for Parasitology 1979;9: 241-249. Control of foodborne trematode infections. Clinical Microbiology Reviews 2009;22:466-483. AJR American Journal of Roentgenology 1992;159:39-43. Once mature flukes have inhabited the lung (in the absence of treatment, this stage of infection may persist for 20 years in humans), the most common complaint is recurrent hemoptysis with chocolate-colored sputum (which is a mixture of blood, inflammatory cells, and Paragonimus eggs) and a chronic cough. 2009;103:1019-23 [PubMed], 44. Clinical features of recently diagnosed pulmonary paragonimiasis in Korea. .item01 {
After a complex process of multiplication and different developmental steps, cercariae are released, which infect the second intermediate crustacean hosts (5, 34). Odermatt P, Nanthaphone S, Barennes H, Chanthavysouk K, Tran DS, Kosanouvong B, Keola S, Mathouchanh P, Choumlivong K, Keoluangkhot V, Phoumindr N, Nanthanavone S, Phrommala S, Degremont A, Strobel M. Improving tuberculosis case detection rate with a lay informant questionnaire: an experience from the Lao People's Democratic Republic. 
Lung radiology in the tropics. Transbronchial biopsies may also confirm the diagnosis. [PubMed], 21. Lancet Infect Dis. Prominent leukocytosis with eosinophilia occurs during early pulmonary parenchymal involvement but later resolves or is minimal. Unlike adjunctive treatment for neurocysticercosis in which corticosteroids are introduced to reduce mounting cerebral inflammation in response to cysticercus larva lysis after antiparasitic treatment, there are no convincing data to support the benefit of corticosteroids used as adjunctive therapy for cerebral paragonimiasis. width: 100%; [PubMed], 29. Treatment has been mainly by the use of emetine in two courses consisting of 1 grain (0.06 gram) daily by hypodermic injection for 7 days, with a period of 1 week's rest, then a repetition of the treatment. AJR American Journal of Roentgenology 1994;162:141-145. Lipiodol oil instillations in 6 cases failed to demonstrate any dilation of the bronchi or connection with cavities except in one instancethere were two small pools of oil in the upper right lobe. Keiser J, Utzinger J. and amebic encephalitis (e.g. Eosinophilic pneumonias. Johnson RJ, Jong EC, Dunning SB, Carberry WL, Minshew BH. It is rare for cerebral symptoms to occur without evidence of chest disease and, in the majority of cases (70%), pulmonary symptoms occur first (14).
Yokogawa M. Experimental chemotherapy of paragonimiasis. More advanced serological tests, which are currently being researched, include a colloidal gold immunochromatographic strip for detection of P. skrjabini infections (44), and protein microarray for the rapid, sensitive, and high-throughput diagnosis of disease specific antibodies of paragonimiasis and other helminth infections (10). background: #ddd; P. heterotremus, P. hueitungensis P. miyazakii, P. skrjabiniP. In many patients on a percussion of the chest, it is possible to demonstrate hyperresonance of varying degree, but the breath sounds are essentially normal. Handb Clin Neurol. The penetration of juvenile worms through the diaphragm into the pleural cavity can cause pleural effusion or pneumothorax. WHO Tech. American Journal of Tropical Medicine and Hygiene 1988;39:469-471. Slesak G, Inthalad S, Basy P, Keomanivong D, Phoutsavath O, Khampoui S, Grosrenaud A, Amstutz V, Barennes H, Buisson Y, Odermatt P. Ziehl-Neelsen staining technique can diagnose paragonimiasis. Praziquantel is a heterocyclic azoquinoline compound that is effective against pulmonary paragonimiasis and all forms of ectopic infections. Complications of cysts include pleural effusion, empyema, and pneumothorax (14, 15, 17, 29, 30, 42). kellicotti, P. mexicanus, P. miyazakii P. siamensis, and P. uterobilateralis (5, 21). [PubMed], 39. Mehlhorn H, Kojima S, Rim HJ, Ruenwongsa P, Andrews P, Thomas H, Bunnag B. Ultrastructural investigations on the effects of praziquantel on human trematodes from Asia: Clonorchis sinensis, Metagonimus yokogawai, Opisthorchis viverrini, Paragonimus westermani and Schistosoma japonicum. Lung flukes are hermaphroditic trematodes. 2013;114:283-96. Pediatr Neurol. Vanijanonta S, Bunnag D, Harinasuta T. Radiological findings in pulmonary paragonimiasis heterotremus. Food does not interfere with, but conversely enhances systemic absorption of triclabendazole. Parasite eggs, produced by the adult worms in the lungs of the final host, are released via sputum and / or feces. Ph.D., Once the parasites reach the lung, patchy airspace consolidation can occur, a phenomenon that reflects the presence of an exudative or hemorrhagic pneumonia which can cavitate. Cerebral Paragonimiasis: Central nervous system (CNS) involvement, caused by aberrant migration of juvenile flukes through the foramina of the skull (commonly via the jugular foramen) has been estimated to occur in 0.8% of all cases of paragonimiasis (8). Lipiodol oil instillations into the bronchi for diagnostic purposes seemed to give a measure of relief from the symptoms of cough, and in 1 case the patient stated that the bloody discharge was less. 1Pyengyang Union Christian Hospital, Korea. However, the effectiveness of this community intervention has not yet been documented. Sawanyawisuth K, Chotmongkol V. Eosinophilic meningitis. Praziquantel (25 mg/kg tid for 2 days) is the drug of choice for paragonimiasis (21, 46). Korean J Parasitol. Cerebrospinal fluid pleocytosis with high eosinophil count is common. Neuroradiology 1988;30:31-34. [PubMed], 13. Chen JX, Chen MX, Ai L, Chen JH, Chen SH, Zhang YN, Cai YC, Zhu XQ, Zhou XN. Other symptoms which have been recorded are: fever, chills, night sweats, shortness of breath, distress in the chest, loss of appetite, loss of weight, and indigestion. Once penetration of the diaphragm and migration into the pleural cavity has occurred (2 to 8 weeks postinfection), patients may have pleuritic chest pain, which is often bilateral. The ecologic requirements of the first and second intermediate hosts, in combination with the presence of the reservoir hosts and the widespread habit of the local population to consume raw or insufficiently cooked crab and crayfish govern the focal transmission of paragonimiasis and explain patchy distribution patterns of the disease (21). Bulletin of the World Health Organization 2007;85:727-731. J Neurosurg Pediatr 2015;15: 101-106. display: flex; The American Journal of Tropical Medicine and Hygiene, The Organization of the Viscerotome Service of the Brazilian Cooperative Yellow Fever Service, Effects of Protective Immune Serum on the Yields of Parasites and Pulmonary Cell Reactions in Schistosome-Infected Rats, Transactions of the American Society of Tropical Medicine, Thirty-First Annual Meeting, https://doi.org/10.4269/ajtmh.1937.s1-17.101, Click here to view the full Terms and Conditions. Diagnostic dilemmas in helminthology: what tools to use and when? Human Paragonimus spp. Wany Y, Wang L, Zhang J, Wang G, Chen W, Chen L, Zhang X. Severe pleuropulmonary paragonimiasis 8 years after emigration from a region of endemicity. 2012;6;e1899. (1985). Bergquist R, Johansen MV, Utzinger J. [PubMed], 38. [PubMed], 7. Therefore, paragonimiasis should always be included in the differential diagnosis for patients having lung lesions associated with eosinophilia and/or elevated serum IgE level, especially for those living in endemic areas. Geneva, World Health Organization. Clinics in Chest Medicine 2002;23:421-431. A massive influx of Ca2+ results in muscle contraction, which occurs within 10-20 seconds and leads to spastic paralysis of the flukes. [PubMed], 15. [PubMed]. Clinics in Chest Medicine 2002;23:409-420. Frst T, Keiser J, Utzinger J. [PubMed], 14. Pulmonary Paragonimiasis: Clinical manifestations depend on the stage of infection. Fried (ed. Johnson RJ, Johnson JR. Paragonimiasis in Indochinese refugees. Within the lung, which is the main habitat of adult Paragonimus flukes, the parasites form areas of inflammation surrounded by eosinophils, neutrophils, and later mononuclear leukocytes. Most of these patients under times of stress and strain, fatigue, or other unfavorable conditions, again develop blood-tinged sputum in the morning, and the ova again make their appearance, even after a lapse of several years. Clinical and radiographic findings may resemble those of lung cancer (having high fluorodeoxyglucose uptake on positron emission tomography (PET) with 18-fluorodeoxyglucose) (16, 22, 45), tuberculosis 16 mesothelioma, or metastatic malignancy (27). margin: 0; Singh TN, Kananbala S, Devi KS.
Trends in Parasitology 2009;25:151-156. Parasite egg detection rates in sputum or bronchoscopic aspirates are about 50% (39) and 24-hour sputum collection enhances the sensitivity of egg detection. As pulmonary parenchymal involvement occurs, leukocytosis and prominent blood eosinophilia are commonly seen. The unspecificity of some of these symptoms renders differential diagnosis difficult. 849. Trans R Soc Trop Med Hyg. It is important to note that Ziehl-Neelsen staining or modified acid-fast staining techniques (e.g., Kinyoun stain), that are commonly employed for the microscopic diagnosis of pulmonary tuberculosis, also have a high sensitivity for detection of Paragonimus eggs in sputum samples (36). Clinical Microbiology Reviews Clin Microbiol Rev. The true extent of animal reservoir hosts for human infection is not known. J Vet Diagn Invest. [PubMed], 4. The global burden of human food-borne trematodiasis: a systematic review and meta-analysis. Within this fibrous capsule, the flukes mature and begin egg production, typically 8 weeks post infection. Handb Clin Neurol. CT findings of cerebral paragonimiasis in the chronic state. 2014;109:849-55. [PubMed], 18. 2011;5:e1048. N Engl J Med. hematologic malignancies) (32). Ann Afr Med. Migratory Subcutaneous Paragonimiasis: Migratory subcutaneous nodules occur in 10% of cases with paragonimiasis. ), Food-borne parasitic zoonoses.
Paragonimiasis acquired in the United States: native and nonnative species. Contrast material-enhanced computer tomography (CT) performed during this stage may show hypoattenuating fluid-filled cysts (5-15 mm) surrounded by hyperattenuating consolidation in the adjacent lung. [PubMed], 2. From experience to date, the instillation of oil seems to be well tolerated, but its therapeutic value can be determined only after extensive clinical trial with control observations. [PubMed], 45. Intradermal skin tests have been utilized for epidemiologic surveys but are no longer popular since novel techniques have become available (5). [PubMed], 49. 1984;34:1193-6. The American Review of Respiratory Disease 1983;128:534-538. More than 50 species have been described (9). The differential diagnosis includes among others: bronchiectasis, tuberculosis, penumonia, mitral stenosis, myocarditis, pleurisy with or without effusion, lung absecess, amebic abscess of the lung, infestations of the lung due to the presence of the larvae of ascaris, bilharzia, or filaria. Pleural effusions are exudative and laden with eosinophils. 2013;25:620-6. 2010;107:1391-7. 2013;26:493-504. Diaz JH. Likewise, a positive serology does not definitely diagnose infection with the P. westermani species; rather, it confirms infection with one of many Paragonimus species (5). 5. In the People's Republic of China, marinated crabs are consumed to relieve back pain. Pleuropulmonary paragonimiasis: radiologic findings in 71 patients. The habit of eating freshwater crab or crayfish raw or inadequately cooked is the key risk factor of acquiring a Paragonimus infection. parasitology taenia solium echinococcus infective saginata