Presentation
Here we present a child with cerebral paragonimiasis. She presented with new onset seizures in the setting of a febrile illness. [ncbi.nlm.nih.gov]
Entire Body System
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Fever
These nine patients, aged 10-32 years, had fever, cough, pleural effusion, and eosinophilia. All had eaten raw or undercooked crayfish from rivers in Missouri while on canoeing or camping trips within 4 months of illness onset. [ncbi.nlm.nih.gov]
Patient 3 Patient 3 was a previously healthy 31-year-old male who presented with a 2-week history of fevers and pharyngitis. [doi.org]
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Fatigue
A 94-year-old female with end-stage renal disease presents with fever, fatigue, and hematochezia. She had previously resided in Hunan Province, China, and Myanmar, and she immigrated to Taiwan 30 years ago. Colonoscopy revealed a colonic ulcer. [ncbi.nlm.nih.gov]
After several days, these initial symptoms may be followed by symptoms such as fatigue, fever, and chest pain. Symptoms of paragonimiasis may appear similar to the symptoms of tuberculosis. [newsmax.com]
Worldwide distribution Age More common in younger patients Gender Males appear to be more commonly infected Ethnicity No ethnic predilection Site Infection can involve Lung Brain Skin/subcutis Presentation Symptoms Abdominal pain Diarrhea Nausea Vomiting Fatigue [basicmedicalkey.com]
Symptoms Initial signs and symptoms may be diarrhea and abdominal pain followed several days later by fever, chest pain, and fatigue. [dshs.state.tx.us]
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Camping
All had eaten raw or undercooked crayfish from rivers in Missouri while on canoeing or camping trips within 4 months of illness onset. [ncbi.nlm.nih.gov]
On further questioning the parents acknowledged that partially cooked crayfish had been part of the family's diet while they stayed in a refugee camp in Thailand en route to the United States. [pidj.com]
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Vietnamese
The results of molecular phylogenetic analyses of Vietnamese Paragonimus species provides new insights on the phylogeny and taxonomy of the genus Paragonimus. [ncbi.nlm.nih.gov]
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Movement Disorder
Most symptoms were markedly improved after treatment, but mild movement disorders combined with impaired memory and personality changes remained in a small number of patients. [ncbi.nlm.nih.gov]
Respiratoric
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Cough
These nine patients, aged 10-32 years, had fever, cough, pleural effusion, and eosinophilia. All had eaten raw or undercooked crayfish from rivers in Missouri while on canoeing or camping trips within 4 months of illness onset. [ncbi.nlm.nih.gov]
It causes chronic inflammatory reactions and the first effects are usually dry cough which may transform in to a productive cough with purulent sputum or hemoptysis before long. [explainmedicine.com]
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Pleural Effusion
The pleural effusion gradually disappeared after the medication. CONCLUSIONS: This patient had cutaneous paragonimiasis with a skin tumor that was diagnosed prior to the expression of a pleural effusion. [ncbi.nlm.nih.gov]
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Hemoptysis
Paragonimiasis is a cause of parasitic hemoptysis worldwide. Paragonimiasis is infrequently encountered in North America and is usually not considered in the differential diagnosis of hemoptysis unless specific risk factors are known. [ncbi.nlm.nih.gov]
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Chronic Cough
We found that the village leaders report on “blood in sputum” had a higher and in combination of with the presence of “chronic cough” a maximal sensitivity. [journals.plos.org]
Patients with chronic cough were interviewed, examined, and requested to submit two sputum samples which were processed using Ziehl-Neelsen method to detect acid-fast bacilli (AFB), and NaOH concentration technique for the detection of Paragonimus ova [ncbi.nlm.nih.gov]
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Dry Cough
Initial symptoms may also include dry cough, which then becomes productive with rust-colored or blood-tinged sputum on exertion. [newsmax.com]
The symptoms may also include a dry cough, which later becomes productive with rusty-colored or blood-tinged sputum on exertion, and pleuritic chest pain. [dshs.state.tx.us]
It causes chronic inflammatory reactions and the first effects are usually dry cough which may transform in to a productive cough with purulent sputum or hemoptysis before long. [explainmedicine.com]
The other patient (patient 29), who complained of dry cough and who had a history of paragonimiasis, was classified in the parenchymatous lesion group because his symptoms improved and the parasite-specific antibody titer in his serum dramatically decreased [cid.oxfordjournals.org]
Gastrointestinal
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Abdominal Pain
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. [ncbi.nlm.nih.gov]
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Nausea
METHODS: The authors have encountered 14 cases of cerebral paragonimiasis in patients between the ages of 6 and 16 years (mean age 11.5 years) who presented with sudden headache, nausea, and vomiting. [ncbi.nlm.nih.gov]
Incidence Worldwide distribution Age More common in younger patients Gender Males appear to be more commonly infected Ethnicity No ethnic predilection Site Infection can involve Lung Brain Skin/subcutis Presentation Symptoms Abdominal pain Diarrhea Nausea [basicmedicalkey.com]
Methods The authors have encountered 14 cases of cerebral paragonimiasis in patients between the ages of 6 and 16 years (mean age 11.5 years) who presented with sudden headache, nausea, and vomiting. [thejns.org]
Diarrhea, abdominal pain, nausea, vomiting and urticarial eruption of dermatitis were observed as transient side-effects, less frequently in children than in adults. [ajtmh.org]
Other chronic paragonimiasis symptoms may include: Belly pain Nausea Vomiting Bloody diarrhea Lumps or bumps on the skin of the belly or legs that come and go over time Some people with chronic paragonimiasis have no noticeable symptoms. [webmd.com]
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Recurrent Abdominal Pain
Here, we report an ectopic paragonimiasis case initially presented with recurrent abdominal pain. [ncbi.nlm.nih.gov]
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Pelvic Mass
This is an unusual case of ovarian paragonimiasis mimicking ovarian cancer, which is instructive and informative for differential diagnoses of pelvic masses. [ncbi.nlm.nih.gov]
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Upper Abdominal Pain
The other one is a 62-year-old female patient who was referred to the hospital for 1 month of right upper abdominal pain and fever. [ncbi.nlm.nih.gov]
Eyes
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Hemianopsia
Five cases of cerebral paragonimiasis presenting with hemianopsia, convulsion, and gait disturbance are discussed. The cases were all in the chronic stage. [ncbi.nlm.nih.gov]
Neurologic
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Dysarthria
A 10-yr-old girl presented with sudden-onset dysarthria, right facial palsy and clumsiness of the right hand. Brain imaging showed acute intracerebral hemorrhage in the left frontal area. [ncbi.nlm.nih.gov]
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Akinesia
Echocardiography and angiography demonstrated akinesia of the apex and mid-wall of the left ventricle with preserved contraction of the basal segments, which suggested Takotsubo cardiomyopathy. [ncbi.nlm.nih.gov]
Workup
Ultrasound of the swelling was done for further workup, which showed "a well-defined cystic area with tubular echogenic structure within masseteric muscle suggestive of the remote possibility of the parasitic infestation, Parotid and submandibular glands [ijcasereportsandimages.com]
X-Ray
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Pulmonary Infiltrate
Physicians should be alerted to the possibility of this disease in Asian patients with hemoptysis and pulmonary infiltrates. [ncbi.nlm.nih.gov]
Roentgenograms reveal transient diffuse pulmonary infiltrates. Although the adult worms cause pulmonary disease, the larvae occasionally produce lesions at ectopic sites, such as the brain, liver, gut, skeletal muscle, testes, and lymph nodes. [histopathology-india.net]
Later, once the worms are reproducing in the lung tissue, pulmonary infiltrates and hemoptysis occur, the sputum containing dark brown eggs. [web.stanford.edu]
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Cavitary Lesion
Internal low attenuation, perilesional centrilobular nodules, cavitary lesions, and worm-migration tracts were more frequently found in the paragonimiasis group (P 0.05). [ncbi.nlm.nih.gov]
(b) Photograph of the gross specimen demonstrates an irregular cavitary lesion (arrows). Anchovy sauce content and trophozoites of E histolytica (not shown) were found on the lesion wall. Figure 3b. [pubs.rsna.org]
Ultrasound
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Ovarian Mass
However, a frozen section revealed Paragonimus eggs in the enlarged ovarian mass. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed instead of complete staging. [ncbi.nlm.nih.gov]
Microbiology
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Paragonimus Westermani
[…] by Paragonimus Paragonimus westermani infection edit English paragonimiasis food-borne parasitic infection caused by the lung fluke, most commonly Paragonimus westermani Infection by Paragonimus (disorder) lung fluke disease lung fluke infection pulmonary [wikidata.org]
However, here we describe an exceedingly rare case of Paragonimus westermani with a mass in the pleural cavity. [ncbi.nlm.nih.gov]
This is an illustration of the life cycle of Paragonimus westermani, one of the causal agents of paragonimiasis. Photo courtesy of The Centers for Disease Control and Prevention. [emedicine.com]
Colonoscopy
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Colonic Ulcer
Colonoscopy revealed a colonic ulcer. Biopsy of the colonic ulcer showed ulceration of the colonic mucosa, and many Paragonimus westermani-like eggs were noted. [ncbi.nlm.nih.gov]
Other Pathologies
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Lymphocytic Infiltrate
Transbronchial lung biopsy revealed the presence of pneumonia with mild eosinophilic infiltration but remarkable lymphocytic infiltration. In this patient, high IL-5 levels in both BALF and pleural effusion could explain the remarkable eosinophilia. [ncbi.nlm.nih.gov]
Other ECG Findings
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Ischemic Changes
Cardiac involvement accompanied with old and recent-onset myocardial ischemic changes resulted in death of this patient. Here, we report a very rare case of malignant mesothelioma with a concomitant infection of parasitic lung fluke. [ncbi.nlm.nih.gov]
Pleura
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Pleural Effusion
The pleural effusion gradually disappeared after the medication. CONCLUSIONS: This patient had cutaneous paragonimiasis with a skin tumor that was diagnosed prior to the expression of a pleural effusion. [ncbi.nlm.nih.gov]
Treatment
Most patients with paragonimiasis are cured by standard praziquantel treatment. However, several cases have been reported to have unsatisfactory responses to the standard praziquantel treatment. [ncbi.nlm.nih.gov]
Prognosis
BACKGROUND AND PURPOSE: The early diagnosis of cerebral paragonimiasis (CP) is essential for a good prognosis. We seek to provide references for early diagnosis by analyzing the imaging characteristics of cerebral paragonimiasis. [ncbi.nlm.nih.gov]
The prognosis in pulmonary paragonimiasis is good, but ectopic lesions of brain are often fatal, even with aggressive treatment. The worms provoke leukocytic infiltrates and later, fibrous encapsulation. [histopathology-india.net]
If the patient had possessed cancer with advanced metastasis, the opportunity for surgery would have been lost and the patient would receive a poor prognosis ( 11 ). [spandidos-publications.com]
Early diagnosis and timely treatment of this disease are vital for a positive prognosis. [thejns.org]
/Age (y)/Sex History Lung Lesion Onset of Symptoms Invaded Site Peripheral Eosinophilia, 10 9 /L Eosinophils in CSF Tx Prognosis 1/6/M Yes Yes Seizure Frontotemporal insula 0.04 / Praziquantel Cured 2/9/M Yes No HA, blurred vision Trigonum, thalamus 0.42 [stroke.ahajournals.org]
Etiology
Our work suggests that P. heterotremus may be the main etiological agent of human paragonimiasis in this locality. [ncbi.nlm.nih.gov]
TERMINOLOGY Synonyms Pulmonary distomiasis, lung fluke disease, parasitic hemoptysis, tojil (earth-borne disease), and gregarinosis Definitions Infectious condition caused by trematode ETIOLOGY/PATHOGENESIS Environmental Exposure Raw or partially cooked [basicmedicalkey.com]
Paragonimiasis was suspected in 21 of the patients who were referred to our laboratory, including 3 who tested positive for parasite eggs, and 9 patients were referred for screening for parasitic diseases of unknown etiology. [cid.oxfordjournals.org]
Epidemiology
Intradermal test, ELISA and Dot-immunogold filtration assay (DIGFA) were used for diagnosis and epidemiological survey of paragonimiasis. [ncbi.nlm.nih.gov]
Pathophysiology
ISBN 978-0340663202. a b c d "Paragonimiasis: Background, Pathophysiology, Epidemiology". 2016-06-20. a b c d e "Paragonimiasis". Center for Global Health, U.S. Centers for Disease Control and Prevention (CDC). 2010-10-13. Retrieved 2012-09-06. [en.wikipedia.org]
Prevention
Preventive antiepileptic drugs should be used along with the administration of parasiticide. [ncbi.nlm.nih.gov]
Photo courtesy of The Centers for Disease Control and Prevention. [emedicine.com]