Presentation
The physical exam presented diffuse rales in both hemithoraces. [scielo.br]
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
- Fever
Clinical manifestations ranges from non-specific symptoms like pain abdomen, diarrhea, urticarial rashes, fever to pleuropulmonary symptoms like cough, hemoptysis, chest pain and dyspnea. 48 yrs, female presented at TUTH emergency with fever on and off [jnma.com.np]
Hacking cough that persists for 5 days or more with clear, yellow, white, or green phlegm, absence of fever/ low grade fever may indicate bronchitis, another complication of the disease. [2,3,4] Difficulty in breathing This is due to primary infestation [explainmedicine.com]
Physicians should consider the possibility that patients who present with cough, fever, hemoptysis, and eosinophilia may have paragonimiasis. [ncbi.nlm.nih.gov]
On migration of flukes into the lungs, patients can experience fevers, cough productive of brownish sputum, and occasionally hemoptysis as early signs of chronic pulmonary infection. [visualdx.com]
- 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]
This may be followed several days later by fever, chest pain, and fatigue. The symptoms may also include a dry cough initially, which later often becomes productive with rusty-colored or blood-tinged sputum on exertion. [cdc.gov]
Symptoms Initial signs and symptoms may be diarrhea and abdominal pain followed several days later by fever, chest pain, and fatigue. [dshs.texas.gov]
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]
- Unconsciousness
Fatal outcomes were significantly associated with being elderly; no administration of ribavirin; and the presence of a cough, hemorrhaging, and unconsciousness. [cdc.gov]
Respiratoric
- Cough
In symptomatic cases, abdominal pain and diarrhea develop 2 days to 2 weeks after infection, followed by fever, cough, chest pain, urticaria, and eosinophilia. Acute symptoms may last for several weeks. [accessmedicine.mhmedical.com]
[…] for 9 months, cough and shortness of breath for 3 months, lethargy, malaise and urticaria with history of raw crab intake one month prior to the onset of symptoms. [jnma.com.np]
During the chronic phase, pulmonary manifestations include cough, expectoration of discolored sputum, hemoptysis, and chest radiographic abnormalities. [phsource.us]
There can be chronic cough and difficulty breathing. Infection with a large number of the parasites can lead to coughing fits with blood-tinged sputum; the sputum may be brown because of the Paragonimus eggs being coughed up. [southernnevadahealthdistrict.org]
- Pleural Effusion
In one study, Singh et al. [2] reported bilateral pleural effusion in 9 out of 45 paragonimiasis cases in children and in other Singh et al. [3] reported three cases of pleuropulmonary paragonimiasis associated with pleural effusion. [ijpmonline.org]
Patients with pleural effusion also had parenchymal lesions. No pneumothorax or hydropneumothorax was found. Unilateral pleural effusion was more common than bilateral pleural effusion (seven versus four patients). [ncbi.nlm.nih.gov]
Pleural lesions such as pleural effusion or pneumothorax are also often observed in infected patients. Johnson and Johnson9 noted that 48% of patients had pleural effusions. [thoracickey.com]
- 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]
This patient was treated with a course of praziquantel, and the hemoptysis resolved within 2 months. An 18-year-old man presented with a 1-year history of episodic hemoptysis. [nejm.org]
During the chronic phase, pulmonary manifestations include cough, expectoration of discolored sputum, hemoptysis, and chest radiographic abnormalities. [cdc.gov]
- 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]
Both share similar clinical manifestations, which include chronic productive cough, hemoptysis, dyspnea, fever, weight loss, and night sweats. [ncbi.nlm.nih.gov]
Manifestations of pulmonary infection develop slowly and include chronic cough, chest pain, hemoptysis, and dyspnea; the clinical picture resembles and is often confused with TB. [merckmanuals.com]
- Dry Cough
The symptoms may also include a dry cough initially, which later often becomes productive with rusty-colored or blood-tinged sputum on exertion. The symptoms of paragonimiasis can be similar to those of tuberculosis. [cdc.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]
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.texas.gov]
When the worms finally reach the lungs, symptoms may include: • Dry cough (cough with little to no phlegm) • Phlegm that is stained with blood, or is rust-colored and smells fishy • Chest or back pain • Difficulty breathing • Fever Symptoms and signs [healthypilipinas.ph]
Gastrointestinal
- Abdominal Pain
Here, we report an ectopic paragonimiasis case initially presented with recurrent abdominal pain. [ncbi.nlm.nih.gov]
Clinical Presentation The acute phase (invasion and migration) may be marked by diarrhea, abdominal pain, fever, cough, urticaria, hepatosplenomegaly, pulmonary abnormalities, and eosinophilia. [cdc.gov]
Clinical Features: The acute phase (invasion and migration) may be marked by diarrhea, abdominal pain, fever, cough, urticaria, hepatosplenomegaly, pulmonary abnormalities, and eosinophilia. [phsource.us]
In symptomatic cases, abdominal pain and diarrhea develop 2 days to 2 weeks after infection, followed by fever, cough, chest pain, urticaria, and eosinophilia. Acute symptoms may last for several weeks. [accessmedicine.mhmedical.com]
- 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]
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]
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]
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]
Neurologic
- Confusion
Chest radiographs may show varied abnormalities of the lungs or pleura, including infiltrates, nodules, cavities, and fibrosis, and the findings can be confused with those of tuberculosis. [accessmedicine.mhmedical.com]
Abdominal paragonimiasis raises a considerable diagnostic challenge to clinicians, because it is uncommon and may be confused with other abdominopelvic inflammatory diseases, particularly peritoneal tuberculosis, and peritoneal carcinomatosis. [ncbi.nlm.nih.gov]
- Irritability
Abstract The authors present a case from a 59 years old white female Brazilian patient, based in Salvador-Bahia, Brazil's northeastern side area, who experienced irritative cough and progressive dyspnea, and, after 18 months, was admitted to a hospital [ncbi.nlm.nih.gov]
The irritative low-productive cough started in July 1998 associated with progressive dyspnea. Eighteen months afterwards, the patient was dyspneic even when resting, when she was then hospitalized. [scielo.br]
With the development of paragonimosis, the following symptoms are observed: chest pain cough with a trace of blood elevated body temperature to 40 degrees; tachycardia increased physical fatigue irritability, a sharp change of mood for no apparent reason [brulanta.com]
The nodules are firm, tender, a few millimeters to 10 cm, and somewhat irritating. They are often located in the lower abdomen, inguinal region, and thigh and are somewhat mobile. Ulcers or abscesses can also occur in skin or subcutaneous tissue. [med-chem.com]
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
- Pulmonary Infiltrate
Physicians should be alerted to the possibility of this disease in Asian patients with hemoptysis and pulmonary infiltrates. [ncbi.nlm.nih.gov]
infiltration and nine cases showed massive pleural effusion without pulmonary infiltration. [semanticscholar.org]
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]
- Cavitary Lesion
CONCLUSIONS: The presence of internal low attenuation and perilesional centrilobular nodules associated with pulmonary consolidative lesions, along with cavitary lesions and worm-migration tracts, is more frequent in patients with paragonimiasis than [ncbi.nlm.nih.gov]
Chest radiography demonstrated right lower lobe nodules and cavitary lesions [Figure 1]a and [Figure 1]b. [ijam-web.org]
(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]
- Multiple Cavitary Lung Lesions
Multiple cavitary lung lesions on CT: imaging findings to differentiate between malignant and benign etiologies. J Bras Pneumol. 2020;46(2):e20190024. https://doi.org/10.36416/1806-3756/e20190024. [cardiothoracicsurgery.biomedcentral.com]
Microbiology
- Paragonimus Westermani
Eight species of Paragonimus lung flukes cause human disease. The most important is Paragonimus westermani. [accessmedicine.mhmedical.com]
[…] 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]
Keywords Subcutaneous nodule Paragonimus westermani Histopathology Introduction Paragonimiasis is a food-borne infection caused by Paragonimus parasites, such as Paragonimus westermani and Paragonimus skrjabini miyazakii. [jmedicalcasereports.biomedcentral.com]
Pleura
- Pleural Effusion
In one study, Singh et al. [2] reported bilateral pleural effusion in 9 out of 45 paragonimiasis cases in children and in other Singh et al. [3] reported three cases of pleuropulmonary paragonimiasis associated with pleural effusion. [ijpmonline.org]
Patients with pleural effusion also had parenchymal lesions. No pneumothorax or hydropneumothorax was found. Unilateral pleural effusion was more common than bilateral pleural effusion (seven versus four patients). [ncbi.nlm.nih.gov]
Pleural lesions such as pleural effusion or pneumothorax are also often observed in infected patients. Johnson and Johnson9 noted that 48% of patients had pleural effusions. [thoracickey.com]
Treatment
Initial tuberculosis treatment and current treatment with praziquantel controlled both conditions. [archbronconeumol.org]
Is there treatment? Yes, there is treatment. Once the diagnosis is made, effective treatment for paragonimiasis is available from a physician. How can I prevent Paragonimus infection? Never eat raw freshwater crabs or crayfish. [cdc.gov]
Morphologic comparison with other intestinal parasites Treatment: Praziquantel* is the drug of choice to treat paragonimiasis. [phsource.us]
The treatment for M. tuberculosis and MAC complex was initiated, and the treatment with praziquantel was repeated. The PCR exam and sputum culture were positive for M. tuberculosis, and the treatment for MAC-complex was then interrupted. [scielo.br]
Close follow-up after the initial treatment is necessary especially for such patients. [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]
Prognosis This is good with the correct treatment. [patient.info]
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]
Etiology
Etiology Life Cycle of Paragonimus Paragonimus is a highly adapted organism that reproduces through a complex life cycle. The definitive host harbors the adult worm in the lung, where it produces eggs that are voided from the host in sputum. [thoracickey.com]
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]
Internal Medicine 54, 179–186.CrossRefGoogle Scholar Wang, CQ, Yang, SJ, Wang, DJ, Pan, HM, Lv, QY, Qiu, MS, Li, XF and Gan, YQ (2009) Investigation on the etiology of Paragonimiasis skrjabini in Xingshan County locating the Reservoir Area of Three Gorges [cambridge.org]
Epidemiology
Autor : Palabras clave : PARAGONIMUS;PARAGONIMIASIS;EPIDEMIOLOGY;ECUADOR Fecha de publicación : 2014 Citación : Calvopiña M. et al. (2014). Current status of Paragonimus and paragonimiasis in Ecuador. [repositorio.educacionsuperior.gob.ec]
Intradermal test, ELISA and Dot-immunogold filtration assay (DIGFA) were used for diagnosis and epidemiological survey of paragonimiasis. [ncbi.nlm.nih.gov]
Pathophysiology
Pathophysiology The life cycle of these flukes involves 2 intermediate hosts plus humans. Its complex life cycle involves 7 distinct phases: egg, miracidium, sporocyst, redia, cercaria, metacercaria, and adult. [emedicine.com]
Prevention
Preventive antiepileptic drugs should be used along with the administration of parasiticide. [ncbi.nlm.nih.gov]
This will help in preventing re-infection or passing on the infection to others. Complications Paragonimiasis may cause distressing complications. [privatehealth.co.uk]
We also work to prevent further spread of the illness in the community. Visit the Disease Report Investigation Process webpage to learn more. References: Suguyama, H et.al. [southernnevadahealthdistrict.org]
How can I prevent Paragonimus infection? Never eat raw freshwater crabs or crayfish. Cook crabs and crayfish to at least 145°F (~63°C). Travelers should be advised to avoid traditional meals containing undercooked freshwater crustaceans. [cdc.gov]