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Zhang H, Mu M, He X, Yin Y. Intra-abdominal paragonimiasis presenting as abscesses: A case report. Asian J Surg 2023; 46:1004-1005. [PMID: 35963684 DOI: 10.1016/j.asjsur.2022.07.108] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 07/21/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Haidong Zhang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Mingchun Mu
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xin He
- Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yuan Yin
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
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Farag MA, Mansour ST, Nouh RA, Khattab AR. Crustaceans (shrimp, crab, and lobster): A comprehensive review of their potential health hazards and detection methods to assure their biosafety. J Food Saf 2022. [DOI: 10.1111/jfs.13026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Mohamed A. Farag
- Pharmacognosy Department, College of Pharmacy Cairo University Cairo Egypt
| | - Somaia T. Mansour
- Chemistry Department, School of Sciences & Engineering The American University in Cairo New Cairo Egypt
| | - Roua A. Nouh
- Chemistry Department, School of Sciences & Engineering The American University in Cairo New Cairo Egypt
| | - Amira R. Khattab
- Pharmacognosy Department, College of Pharmacy Arab Academy for Science, Technology and Maritime Transport Alexandria Egypt
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Choi JW, Lee CM, Kim SJ, Hah SI, Kwak JY, Cho HC, Ha CY, Jung WT, Lee OJ. Ectopic peritoneal paragonimiasis mimicking tuberculous peritonitis: A care report. World J Clin Cases 2022; 10:5359-5364. [PMID: 35812672 PMCID: PMC9210911 DOI: 10.12998/wjcc.v10.i16.5359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 10/07/2021] [Accepted: 04/04/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The most common site of paragonimiasis is in the lungs. The migratory route passes through the duodenal wall, peritoneum, and diaphragm to the lungs; thus, the thoracic cavity and central nervous system, as well as the liver, intestine, and abdominal cavity may be involved. Here, we present a case of intraperitoneal paragonimiasis without other organ involvement, mimicking tuberculous peritonitis.
CASE SUMMARY A 57-year-old man presented with recurrent abdominal pain for 4 wk. Physical examination revealed tenderness in the right lower quadrant. Laboratory findings showed complete blood counts within the normal range without eosinophilia. Multiple reactive lymph nodes and diffuse peritoneal infiltration were noted on abdominal computed tomography (CT). There were no abnormalities on chest CT or colonoscopy. Intraoperative findings of diagnostic laparoscopy for the differential diagnosis of tuberculous peritonitis and peritoneal carcinomatosis included multiple small whitish nodules and an abscess in the peritoneum. Pathological reports confirmed the presence of numerous eggs of Paragonimus westermani (P. westermani). A postoperative serum enzyme-linked immunosorbent assay revealed P. westermani positivity. Persistent and repetitive history-taking led him to retrospectively recall the consumption of freshwater crab. After 3 d of treatment with praziquantel (1800 mg; 25 mg/kg), he recovered from all symptoms.
CONCLUSION In patients who require diagnostic laparoscopy for the differential diagnosis of tuberculous peritonitis and peritoneal carcinomatosis, repetitive history-taking and preoperative serologic antibody tests against Paragonimus may be helpful in diagnosing intraperitoneal paragonimiasis without other organ involvement.
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Affiliation(s)
- Jung Woo Choi
- Department of Internal Medicine, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju 52727, South Korea
| | - Chang Min Lee
- Department of Internal Medicine, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju 52727, South Korea
- Institute of Health Sciences, Gyeongsang National University, Jinju 52828, South Korea
| | - Seong Je Kim
- Department of Internal Medicine, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju 52727, South Korea
| | - Se In Hah
- Department of Internal Medicine, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju 52727, South Korea
| | - Ji Yoon Kwak
- Department of Internal Medicine, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju 52727, South Korea
| | - Hyun Chin Cho
- Department of Internal Medicine, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju 52727, South Korea
- Institute of Health Sciences, Gyeongsang National University, Jinju 52828, South Korea
| | - Chang Yoon Ha
- Department of Internal Medicine, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju 52727, South Korea
- Institute of Health Sciences, Gyeongsang National University, Jinju 52828, South Korea
| | - Woon Tae Jung
- Department of Internal Medicine, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju 52727, South Korea
- Institute of Health Sciences, Gyeongsang National University, Jinju 52828, South Korea
| | - Ok Jae Lee
- Department of Internal Medicine, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju 52727, South Korea
- Institute of Health Sciences, Gyeongsang National University, Jinju 52828, South Korea
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Abstract
Foodborne trematodes (FBT) of public health significance include liver flukes (Clonorchis sinensis, Opisthorchis viverrini, O. felineus, Fasciola hepatica and F. gigantica), lung flukes (Paragonimus westermani and several other Paragonimus spp.) and intestinal flukes, which include heterophyids (Metagonimus yokogawai, Heterophyes nocens and Haplorchis taichui), echinostomes (Echinostoma revolutum, Isthmiophora hortensis, Echinochasmus japonicus and Artyfechinostomum malayanum) and miscellaneous species, including Fasciolopsis buski and Gymnophalloides seoi. These trematode infections are distributed worldwide but occur most commonly in Asia. The global burden of FBT diseases has been estimated at about 80 million, however, this seems to be a considerable underestimate. Their life cycle involves a molluscan first intermediate host, and a second intermediate host, including freshwater fish, crustaceans, aquatic vegetables and freshwater or brackish water gastropods and bivalves. The mode of human infection is the consumption of the second intermediate host under raw or improperly cooked conditions. The major pathogenesis of C. sinensis and Opisthorchis spp. infection includes inflammation of the bile duct which leads to cholangitis and cholecystitis, and in a substantial number of patients, serious complications, such as liver cirrhosis and cholangiocarcinoma, may develop. In lung fluke infections, cough, bloody sputum and bronchiectasis are the most common clinical manifestations. However, lung flukes often migrate to extrapulmonary sites, including the brain, spinal cord, skin, subcutaneous tissues and abdominal organs. Intestinal flukes can induce inflammation in the intestinal mucosa, and they may at times undergo extraintestinal migration, in particular, in immunocompromised patients. In order to control FBT infections, eating foods after proper cooking is strongly recommended.
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Roh CK, Jung MJ. Laparoscopic excision for ectopic peritoneal paragonimiasis mimicking a gastric duplication cyst: A case report. Ann Med Surg (Lond) 2021; 69:102754. [PMID: 34484726 PMCID: PMC8391020 DOI: 10.1016/j.amsu.2021.102754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/17/2021] [Accepted: 08/22/2021] [Indexed: 11/07/2022] Open
Abstract
Introduction Paragonimiasis, lung fluke disease caused by infection with Paragonimus species, is a food-borne parasitic zoonosis. The overriding symptoms of Paragonimus westermani infection include chronic cough, shortness of breath, and pleuritic pain. Extrapulmonary paragonimiasis caused by aberrant parasitic migration is known to occur in a variety of sites such as the brain, abdominal wall, and intraperitoneal cavity. Ectopic paragonimiasis is an uncommon disease that presents with a few clinical manifestations, which makes it difficult to diagnose and treat. Case presentation A 47-year-old man with an unremarkable medical and surgical history presented with a peritoneal lesion that was discovered incidentally on abdominal computed tomography during routine health screening. The patient did not exhibit any associated symptoms such as abdominal pain. The radiologic diagnosis was a gastric duplication cyst and we performed laparoscopic excision of the peritoneal mass. Histopathological examination revealed paragonimiasis, and the result of the skin test for paragonimiasis was positive. The patient was treated with praziquantel. Clinical discussion The diagnosis of ectopic peritoneal paragonimiasis remains challenging due to inexperience, misdiagnosis, and its rarity. Clinicians should bear in mind that an intra-abdominal mass may be related to a parasitic infection. The detection of the ova of Paragonimus parasites in sputum and biopsy specimens may be difficult due to an insufficient amount. Conclusion Clinicians need to thoroughly take the patient's history and clinically suspect parasitic infections. Laparoscopic resection of this rare mass is safe, feasible, and allows for rapid recovery. Ectopic paragonimiasis is a rare disease with a few clinical symptoms. The rarity of ectopic paragonimiasis makes it difficult to diagnose and treat. Clinicians should suspect parasitic infections. The laparoscopic approach could be a treatment option for abdominal masses.
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Affiliation(s)
- Chul Kyu Roh
- Department of Surgery, Ajou University School of Medicine, Suwon, South Korea
| | - Min Jung Jung
- Department of Pathology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Kong L, Hua L, Liu Q, Bao C, Hu J, Xu S. One delayed diagnosis of paragonimiasis case and literature review. Respirol Case Rep 2021; 9:e00750. [PMID: 33959297 PMCID: PMC8080295 DOI: 10.1002/rcr2.750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/19/2021] [Accepted: 03/26/2021] [Indexed: 12/01/2022] Open
Abstract
Human paragonimiasis has been appearing all over the world due to increased human migration, international travel, and worldwide food trading. However, delayed and missed diagnosis rates are also increasing due to atypical clinical manifestations and the lack of disease understanding by clinical workers. We describe the case of a 43-year-old man, who was hospitalized with cough and chest pain for two months. Chest computed tomography (CT) revealed bilateral emphysema, left pleural effusion, and bilateral atelectasis. The hypereosinophilia gave us a clue; ultimately, the diagnosis of paragonimiasis was made through a diet history and a positive result of serum Paragonimus sp. immunoglobulin (Ig) G antibody. Moreover, 27 misdiagnosed paragonimiasis cases in the past decade have been reported. We draw conclusions by summarizing their characteristics for suspicious eosinophilic paragonimiasis patients; we should inquire diet history carefully, test serum IgG antibodies, and try to detect eggs. Once diagnosed, praziquantel is preferred for treatment.
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Affiliation(s)
- Luxia Kong
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Lijuan Hua
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Qian Liu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Chen Bao
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Jiannan Hu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Shuyun Xu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
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Ha JS, Lee JY, Sung WY, Seo SW, Lee WS. A case of paragonimiasis inducing bilateral pneumothorax with lung and liver involvement. Asian Cardiovasc Thorac Ann 2021; 30:339-341. [PMID: 33779317 DOI: 10.1177/02184923211006334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Pulmonary paragonimiasis can occasionally induce bilateral pneumothorax and cause lesions in ectopic organs such as the liver. We report the case of a 26-year-old man who had been treated for bilateral hydropneumothorax one month earlier and returned to the emergency center complaining of epigastric pain that had persisted for four months. After being diagnosed with pulmonary and hepatic paragonimiasis, he was treated with praziquantel and his condition improved without complications.
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Affiliation(s)
- Ji Sung Ha
- Department of Emergency Medicine, 65401Eulji University Hospital, Daejeon, Republic of Korea
| | - Jang Young Lee
- Department of Emergency Medicine, 65401Eulji University Hospital, Daejeon, Republic of Korea
| | - Won Young Sung
- Department of Emergency Medicine, 65401Eulji University Hospital, Daejeon, Republic of Korea
| | - Sang Won Seo
- Department of Emergency Medicine, 65401Eulji University Hospital, Daejeon, Republic of Korea
| | - Won Suk Lee
- Department of Emergency Medicine, 65401Eulji University Hospital, Daejeon, Republic of Korea
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Chen WQ, Deng Y, Zhang YL, Ai L, Chen JX, Lin XM, Du XB, Li P, Zhou RM, Yang CY, Liu Y, Zhang HW, Xu BL, Zhao YL. A case of group infections with Paraginimus species in Henan, Central China. Acta Trop 2020; 202:105111. [PMID: 31351073 DOI: 10.1016/j.actatropica.2019.105111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 07/15/2019] [Accepted: 07/23/2019] [Indexed: 12/29/2022]
Abstract
In July of 2012, mass infections with Paragonimus species were detected in the Henan province sickening 11 of 51 people. In May 2011, these individuals had participated in an excursion during which freshwater crabs were caught and served after being toasted. Before the group infections with Paraginimus species was confirmed, 5 of the 11 patients had been misdiagnosed as tuberculosis (TB) and treated with an anti-TB drug regimen for six months. The most common and typical manifestations were eosinophilia (11/11, 100%) and pulmonary manifestations including, among others, stethalgia and cough (7/11 63.6%). Sero-examination revealed that all 11 patients were seropositive for Paragonimus species. Surprisingly, in our case, one patient presented with hemoptysis and eggs in respiratory secretions, and this is the first time P. skrjabini eggs are detected in the sputum of a patient from the Henan province. Paragonimus metacercariae were collected from 6 of 11 (54.5%) crabs caught at the infection site and were identified as Paraginiumus skrjabini by morphological and molecular examinations. Epidemiological and laboratory evidence confirmed that this is a case of group infection with P. skrjabini. As one of the most neglected tropical diseases (NTD), paragonimiasis should be differentiated diagnosed from TB to avoid the delay of treatment. To our knowledge, this is the second report of a case of group infections with Paraginimus species in Henan, Central China. The first case was reported in 1995. As a kind of food-borne parasitic disease, paragonimiasis should be included in the public health education agenda.
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Oh MY, Chu A, Park JH, Lee JY, Roh EY, Chai YJ, Hwang KT. Simultaneous Paragonimus infection involving the breast and lung: A case report. World J Clin Cases 2019; 7:4292-4298. [PMID: 31911910 PMCID: PMC6940327 DOI: 10.12998/wjcc.v7.i24.4292] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 11/22/2019] [Accepted: 11/26/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Paragonimiasis is a food-borne parasitic infection caused by lung flukes of the genus Paragonimus. Although the most common site of infection is the pleuropulmonary area, the parasite can also reach other parts of the body on its journey from the intestines to the lungs, ending up in locations such as the brain, abdomen, skin, and subcutaneous tissues. Ectopic paragonimiasis is difficult to diagnose due to the rarity of this disease.
CASE SUMMARY Here, we report a rare case of simultaneous breast and pulmonary paragonimiasis in a woman presenting painless breast mass and lung nodule with a history of eating raw trout. To confirm the diagnosis, serologic testing and tissue confirmation of the breast mass were performed. The patient was treated with surgical resection of the mass and praziquantel medication.
CONCLUSION Ectopic paragonimiasis is difficult to diagnose due to the rarity of this disease. Thus, thorough history-taking and clinical suspicion of parasitic infection are important.
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Affiliation(s)
- Moon Young Oh
- Department of Surgery, Seoul National University Hospital, Seoul 156707, South Korea
| | - Ajung Chu
- Department of Radiology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 156707, South Korea
| | - Jeong Hwan Park
- Department of Pathology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 156707, South Korea
| | - Jong Yoon Lee
- Department of Radiology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 156707, South Korea
| | - Eun Youn Roh
- Department of Laboratory Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 156707, South Korea
| | - Young Jun Chai
- Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 156707, South Korea
| | - Ki-Tae Hwang
- Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 156707, South Korea
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Seok H, Sohn TS, Peck KR. A Paragonimiasis Mimicking Gastric Submucosal Tumor. J Korean Med Sci 2019; 34:e45. [PMID: 31044572 PMCID: PMC6374547 DOI: 10.3346/jkms.2019.34.e45] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 11/12/2018] [Indexed: 01/30/2023] Open
Affiliation(s)
- Hyeri Seok
- Division of Infectious Diseases, Department of Medicine, Korea University Ansan Hospital, Ansan, Korea
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Sung Sohn
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyong Ran Peck
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Paragonimus westermani infection manifesting as a pulmonary cavity and adrenal gland mass: A case report. J Infect Chemother 2018; 25:200-203. [PMID: 30213500 DOI: 10.1016/j.jiac.2018.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 07/04/2018] [Accepted: 08/10/2018] [Indexed: 12/14/2022]
Abstract
We report a case of Paragonimus westermani infection simultaneously affecting two separate organs that presented as both a pulmonary cavity and adrenal mass in an immunocompromised host. A 65-year-old male with a previous kidney transplant visited our clinic because of hemoptysis. Chest computed tomography (CT) showed a pulmonary cavity and right adrenal gland mass. The Aspergillus antigen titer in bronchial lavage fluid was elevated and showed positive conversion. It was necessary to differentiate lung cancer with adrenal gland metastasis from a fungal infection with an adrenal gland adenoma. Positron emission tomography CT suggested benign disease, and it was misdiagnosed as pulmonary aspergillosis based on the elevated Aspergillus antigen titer in the bronchial lavage fluid. Owing to the adverse effects of anti-fungal treatment, the patient underwent wedge resection of the lung and P. westermani was confirmed. A careful history revealed that the patient had eaten raw freshwater crabs 3 years earlier, and a test for serum antibodies to P. westermani was positive. Despite treatment with praziquantel, the adrenal mass persisted on 3-month follow-up CT. A right adrenalectomy was performed and a P. westermani infection was confirmed.
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