Paragonimiasis



Paragonimiasis







Key Facts


Terminology



  • Synonyms: Pulmonary distomiasis, lung fluke disease, parasitic hemoptysis, tojil (earth-borne disease), and gregarinosis


  • Infectious condition caused by trematode


Etiology/Pathogenesis



  • Raw or partially cooked crab or crayfish


  • Contaminated drinking water


  • Infectious agent; most common in humans are



    • Paragonimus westermani (Asia)


    • Paragonimus mexicanus (Latin America)


Clinical Issues



  • Infection can involve



    • Lung


    • Brain


    • Skin/subcutis


  • Laboratory results



    • Eosinophilia


  • Treatment



    • Surgical resection


  • Alternative treatment



    • Praziquantel


    • Bithionol


Image Findings



  • Pulmonary mass


Microscopic Pathology



  • Identification of parasite or eggs


  • Granulomatous reaction


  • Necrosis






CT scan of the thorax shows intrapulmonary nodules image. This presentation may be confused with other conditions, including neoplastic processes.






Numerous paracytic structures are present image admixed with calcifications image and minimal inflammatory reaction. These features are in keeping with paragonimiasis.


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 crab or crayfish


  • Contaminated drinking water


Infectious Agents



  • Although there are numerous species of Paragonimus, most common in humans is



    • Paragonimus westermani (Asia)


    • Paragonimus mexicanus (Latin America)



      • Requires 7 different phases in life cycle


      • Requires 3 hosts to complete life cycle


      • Incubation period is ˜ 70 days


CLINICAL ISSUES


Epidemiology



  • 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


    • Vomiting


    • Fatigue


    • Fever


    • Cough


    • Night sweats


    • Chest pain


    • Hemoptysis


    • Hydropneumothorax


  • Asymptomatic


Laboratory Tests



  • Eosinophilia

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Jul 9, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Paragonimiasis

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