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Ikushima I, Yamasaki K, Tahara M, Nemoto K, Akata K, Ikegami H, Nishida C, Muramatsu K, Fujino Y, Matsuda S, Fushimi K, Mukae H, Yatera K. Epidemiologic evaluation of pulmonary paragonimiasis in Japan using a Japanese nationwide administrative database. J Infect Chemother 2024; 30:603-607. [PMID: 38219980 DOI: 10.1016/j.jiac.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/05/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Paragonimiasis is a parasitic disease primarily contracted through consumption of undercooked freshwater crustaceans or wild boar meat. Large-scale nationwide epidemiological data on paragonimiasis are lacking. In this study, we aimed to investigate the nationwide epidemiology of hospitalized patients with paragonimiasis in Japan using a comprehensive nationwide Japanese administrative database. METHODS We evaluated the Japanese Diagnosis Procedure Combination (DPC) data of patients diagnosed with pulmonary paragonimiasis between April 1, 2012 and March 30, 2020. The patients' address and information, including age, sex, treatment (medication: praziquantel; surgery: open thoracotomy or intracranial mass extirpation), Japan coma scale, comorbidities, and length of hospital stay, were extracted. RESULTS Of the 49.6 million hospitalized patients, data were extracted on 73 patients with paragonimiasis, of whom 36 were male and 37 were female. The mean age was 49.7 years and the mean length of stay was 12.5 days. The most frequent comorbidity was pleural effusion (31.5 %), followed by pneumothorax (13.7 %). The sites of ectopic paragonimiasis in organs other than the lung included the liver (5.5 %), skin (4.1 %), and brain (2.7 %). Geographically, most patients were from the Kyushu region (54.8 %), followed by the Kanto region (22.0 %). Fukuoka Prefecture had the highest number of patients (22.0 %) by prefecture. During the study period, an average of 9.1 patients/year were hospitalized with lung paragonimiasis in Japan. CONCLUSION Paragonimiasis has not completely disappeared in Japan; thus, physicians should be aware of paragonimiasis in the Kyushu region, especially in the Fukuoka Prefecture.
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Affiliation(s)
- Issei Ikushima
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kei Yamasaki
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
| | - Masahiro Tahara
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kazuki Nemoto
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kentaro Akata
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Hiroaki Ikegami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Chinatsu Nishida
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Keiji Muramatsu
- Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Shinya Matsuda
- Department of Environmental Epidemiology, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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Zhang KY, Bi Y, Fu XW, Qi M, Wei JL, Gan W, Zhang L, Li X. Peripheral blood eosinophils: an important reference for radiologists to distinguish between pulmonary paragonimiasis and tuberculous pleurisy in children. BMC Infect Dis 2024; 24:571. [PMID: 38851671 PMCID: PMC11162568 DOI: 10.1186/s12879-024-09461-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 06/03/2024] [Indexed: 06/10/2024] Open
Abstract
OBJECTIVE In this study, we examined the value of chest CT signs combined with peripheral blood eosinophil percentage in differentiating between pulmonary paragonimiasis and tuberculous pleurisy in children. METHODS Patients with pulmonary paragonimiasis and tuberculous pleurisy were retrospectively enrolled from January 2019 to April 2023 at the Kunming Third People's Hospital and Lincang People's Hospital. There were 69 patients with pulmonary paragonimiasis (paragonimiasis group) and 89 patients with tuberculous pleurisy (tuberculosis group). Clinical symptoms, chest CT imaging findings, and laboratory test results were analyzed. Using binary logistic regression, an imaging model of CT signs and a combined model of CT signs and eosinophils were developed to calculate and compare the differential diagnostic performance of the two models. RESULTS CT signs were used to establish the imaging model, and the receiver operating characteristic (ROC) curve was plotted. The area under the curve (AUC) was 0.856 (95% CI: 0.799-0.913), the sensitivity was 66.7%, and the specificity was 88.9%. The combined model was established using the CT signs and eosinophil percentage, and the ROC was plotted. The AUC curve was 0.950 (95% CI: 0.919-0.980), the sensitivity was 89.9%, and the specificity was 90.1%. The differential diagnostic efficiency of the combined model was higher than that of the imaging model, and the difference in AUC was statistically significant. CONCLUSION The combined model has a higher differential diagnosis efficiency than the imaging model in the differentiation of pulmonary paragonimiasis and tuberculous pleurisy in children. The presence of a tunnel sign on chest CT, the absence of pulmonary nodules, and an elevated percentage of peripheral blood eosinophils are indicative of pulmonary paragonimiasis in children.
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Affiliation(s)
- Kai-Yi Zhang
- Department of Tuberculosis, Kunming Third People's Hospital/Yunnan Clinical Medical Center for Infectious Diseases, Kunming, 650041, China
| | - Yan Bi
- Department of Radiology, The People's Hospital of Lincang, Lincang, Yunnan, 677000, China
| | - Xu-Wen Fu
- Department of Radiology, Kunming Third People's Hospital/Yunnan Clinical Medical Center for Infectious Diseases, No. 319 of Wujing Street, Guandu District, Kunming, 650041, China
| | - Min Qi
- Department of Radiology, Kunming Third People's Hospital/Yunnan Clinical Medical Center for Infectious Diseases, No. 319 of Wujing Street, Guandu District, Kunming, 650041, China
| | - Jia-Lu Wei
- Department of Radiology, Kunming Third People's Hospital/Yunnan Clinical Medical Center for Infectious Diseases, No. 319 of Wujing Street, Guandu District, Kunming, 650041, China
| | - Wei Gan
- Department of Radiology, Kunming Third People's Hospital/Yunnan Clinical Medical Center for Infectious Diseases, No. 319 of Wujing Street, Guandu District, Kunming, 650041, China
| | - Le Zhang
- Department of ICU, Kunming Third People's Hospital/Yunnan Clinical Medical Center for Infectious Diseases, Kunming, 650041, China.
| | - Xiang Li
- Department of Radiology, Kunming Third People's Hospital/Yunnan Clinical Medical Center for Infectious Diseases, No. 319 of Wujing Street, Guandu District, Kunming, 650041, China.
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Mu X, Zhao M, Zhao J. Pancreatic Paragonimiasis in Children: A Case Report. Pancreas 2024; 53:e378-e379. [PMID: 38345919 DOI: 10.1097/mpa.0000000000002307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2024]
Abstract
ABSTRACT A few pediatric cases of abdominal paragonimiasis have been described. Here we describe a case of pulmonary and abdominal paragonimiasis with involvement of the pancreas in a 9-year-old boy. The aim of this study was to analyze the clinical and radiological features of pancreatic paragonimiasis in children and raise the awareness of this disease.
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Affiliation(s)
- Xiaolong Mu
- From the Department of Pediatric Surgery, Shiyan Taihe Hospital
| | - Mingjun Zhao
- From the Department of Pediatric Surgery, Shiyan Taihe Hospital
| | - Junbo Zhao
- Hubei University of Medicine, Shiyan, Hubei, China
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Taku K, Ogata M, Hoshina T, Maruyama H, Yoshida A, Kusuhara K. Serial changes in B-cell subsets and immunoglobulin G4 levels in paragonimiasis. Pediatr Int 2024; 66:e15727. [PMID: 38409883 DOI: 10.1111/ped.15727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/02/2023] [Accepted: 11/17/2023] [Indexed: 02/28/2024]
Affiliation(s)
- Keisuke Taku
- Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Manami Ogata
- Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Takayuki Hoshina
- Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Haruhiko Maruyama
- Division of Parasitology, Department of Infectious Diseases, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Ayako Yoshida
- Laboratory of Veterinary Parasitic Diseases, Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan
- Center for Animal Disease Control, University of Miyazaki, Miyazaki, Japan
| | - Koichi Kusuhara
- Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
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Devi KR, Deka A, Mukherjee D, Kaur H, Narain K. Immunoblotting Identification of Diagnostic Antigens of Paragonimus westermani Type 1 for the Detection of Human Pulmonary Paragonimiasis in North East India. Trop Med Infect Dis 2023; 9:6. [PMID: 38251203 PMCID: PMC10818403 DOI: 10.3390/tropicalmed9010006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/12/2023] [Accepted: 11/23/2023] [Indexed: 01/23/2024] Open
Abstract
Human pulmonary paragonimiasis, an emerging concern in North East India, frequently masquerades as pulmonary tuberculosis due to clinical and radiological similarities, leading to diagnostic challenges. This research aimed to harness the immunoblotting technique to discern immunodiagnostic protein antigens from both adult worm and excretory-secretory (ES) extracts of the prevalent Paragonimus westermani type 1 in Arunachal Pradesh, North East India. We studied the time kinetics of immunoreactive patterns in relation to the duration of infection in rodent models. Immunoblot analyses were also conducted using sera from ELISA-positive patients confirmed with paragonimiasis, facilitating the selection of antigenic extracts with diagnostic potential. Further, ES protein antigens were subjected to 2D immunoblot analysis and immunoreactive protein spots identified using MALDI-TOF MS. The immunoreactivity patterns of ES antigens with sera of paragonimiasis-positive patients were detailed, and specific immunoreactive protein antigens were pinpointed using peptide mass fingerprinting (MALDI-TOF). This work underscores the enhanced diagnostic accuracy when combining ELISA with immunoblotting for pulmonary paragonimiasis in regions like North East India, marked by co-existing helminth infections.
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Affiliation(s)
- Kangjam Rekha Devi
- Indian Council of Medical Research-Regional Medical Research Centre, Dibrugarh 786001, Assam, India; (K.R.D.); (A.D.)
| | - Archana Deka
- Indian Council of Medical Research-Regional Medical Research Centre, Dibrugarh 786001, Assam, India; (K.R.D.); (A.D.)
| | - Debdutta Mukherjee
- Indian Council of Medical Research-Regional Medical Research Centre, Dibrugarh 786001, Assam, India; (K.R.D.); (A.D.)
| | - Harpreet Kaur
- Indian Council of Medical Research-Headquarters, New Delhi 110029, India;
| | - Kanwar Narain
- Indian Council of Medical Research-Regional Medical Research Centre, Dibrugarh 786001, Assam, India; (K.R.D.); (A.D.)
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Song Y, Lee J, Hahn W, Jang Y, Na S, Oh SM, Hwang JH, Lee CS, Choe YH, Hwang JH. Risk factors and clinical features for pulmonary paragonimiasis-associated pneumothorax. PLoS Negl Trop Dis 2023; 17:e0011828. [PMID: 38100524 PMCID: PMC10756554 DOI: 10.1371/journal.pntd.0011828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/29/2023] [Accepted: 11/28/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Pulmonary paragonimiasis, a food-borne zoonotic helminthiasis, is a parasitic disease of the lung caused by infection with trematodes species of the genus Paragonimus. Although pneumothorax has been reported as occuring with paragonimiasis, to date no study has been performed concerning the clinical features and predictive risk factors for this condition. METHODS This retrospective study, which aims to fill this gap, was conducted at Jeonbuk National University Hospital. All patients (aged ≥19 years) were diagnosed with paragonimiasis between May 2011 and December 2021. Medical records were reviewed and information concerning age, sex, vital signs, underlying diseases, clinical signs and symptoms, laboratory findings, radiologic findings, treatment, and clinical outcomes was collected. An odds ratio (OR) for the risk factors associated with pneumothorax was calculated using the binary logistic regression model. RESULTS Among 179 consecutive patients diagnosed with pulmonary paragonimiasis, the postive rate of pneumothorax was 10.6% (19/179). Pneumothorax occurred mostly in the right lung (78.9%, 15/19), and intrapulmonary parenchymal lesions showed an ipsilateral relationship with pneumothorax (94.7%, 18/19). Fifteen patients (78.9%, 15/19) of pneumothorax associated with pulmonary paragonimiasis are accompanied by pleural effusion. Most of patients with pneumothorax (89.5%, 17/19) underwent chest tube insertion as a first treatment. Three patients (15.8%) showed relapses but in no case was a death recorded. Asthma (odds ratio [OR] 8.10, 95% confidence interval [CI] 1.43-45.91), chest pain (OR 8.15, 95% CI 2.70-24.58), and intrapulmonary lesions (OR 8.94, 95% CI 1.12-71.36) were independent risk factors for pulmonary paragonimiasis-associated pneumothorax. CONCLUSIONS Our findings suggest that clinicians should keep in mind the possibility of pneumothorax when approached by patients with pulmonary paragonimiasis complaining of chest pain, accompanied by intrapulmonary lesions or with asthma as an underlying disease.
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Affiliation(s)
- Yunhong Song
- Jeonbuk National University Medical School, Jeonju, Jeonbuk, Republic of Korea
| | - Jeongmin Lee
- Jeonbuk National University Medical School, Jeonju, Jeonbuk, Republic of Korea
| | - Wonchang Hahn
- Jeonbuk National University Medical School, Jeonju, Jeonbuk, Republic of Korea
| | - Yujeong Jang
- Jeonbuk National University Medical School, Jeonju, Jeonbuk, Republic of Korea
| | - Seungwon Na
- Jeonbuk National University Medical School, Jeonju, Jeonbuk, Republic of Korea
| | - Sang-Min Oh
- Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Jeonbuk, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, Jeonbuk, Republic of Korea
- Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Jeonbuk, Republic of Korea
| | - Joo-Hee Hwang
- Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Jeonbuk, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, Jeonbuk, Republic of Korea
- Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Jeonbuk, Republic of Korea
| | - Chang-Seop Lee
- Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Jeonbuk, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, Jeonbuk, Republic of Korea
- Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Jeonbuk, Republic of Korea
| | - Yeong Hun Choe
- Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Jeonbuk, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, Jeonbuk, Republic of Korea
- Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Jeonbuk, Republic of Korea
| | - Jeong-Hwan Hwang
- Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Jeonbuk, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, Jeonbuk, Republic of Korea
- Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Jeonbuk, Republic of Korea
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Wang H, Wang L, Yu D, Luo G, Yang S, Liu Y, Ren T, Wang M. Exudative pleural effusion caused by lung fluke infection: A practical diagnostic approach. Int J Infect Dis 2023; 135:8-11. [PMID: 37507085 DOI: 10.1016/j.ijid.2023.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/07/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
OBJECTIVES Pleural effusion caused by lung fluke is a rare etiology of exudative pleural effusion (EPE), which is often misdiagnosed or delayed. We aim to summarize the diagnosis and treatment course of EPE caused by lung fluke infection and put forward a practical diagnosis approach. METHODS We retrospectively analyzed the diagnosis and treatment of 14 cases of EPE caused by lung fluke infection diagnosed by enzyme-linked immunosorbent assay of serum antibodies or egg detection. RESULTS All patients (100%) with an absolute count of eosinophils in peripheral blood exceeded 0.5 × 109/l, and 10 patients (71.4%) had a history of special ingestion. Eosinophilic PE occurred in 11 patients (78.6%), pleural biopsy of medical thoracoscopic demonstrated eosinophils infiltration in nine patients (64.3%), and parasite eggs in one patient. All patients showed positive intradermal tests for Paragonimus-specific antigens and enzyme-linked immunosorbent assay of serum antibodies to Paragonimus. CONCLUSION For patients with unexplained PE, lung fluke infection should be highly suspected when pleural fluid or pleural biopsy shows eosinophilic PE or eosinophils infiltration, especially for patients with certain diet history.
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Affiliation(s)
- Hansheng Wang
- Department of Pulmonary and Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, People's Republic of China
| | - Lei Wang
- Department of Laboratory, Taihe Hospital, Hubei University of Medicine, Shiyan, People's Republic of China
| | - Dan Yu
- Department of Pathology, Taihe Hospital, Hubei University of Medicine, Shiyan, People's Republic of China
| | - Guoshi Luo
- Department of Pulmonary and Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, People's Republic of China
| | - Shuguo Yang
- Department of Pathogenic Biology, Basic Medical College, Hubei University of Medicine, Shiyan, People's Republic of China
| | - Yan Liu
- Department of Pulmonary and Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, People's Republic of China
| | - Tao Ren
- Department of Pulmonary and Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, People's Republic of China.
| | - Meifang Wang
- Department of Pulmonary and Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, People's Republic of China.
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Maekawa K, Nagayasu E, Hata Y, Hanamure F, Maruyama H, Yamashita A. Paragonimus westermani preadult fluke in a pulmonary necrotizing granulomatous lesion: A case associated with eating soy sauce-marinated raw freshwater crab, "gejang". Pathol Int 2023; 73:373-376. [PMID: 37493110 DOI: 10.1111/pin.13352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 06/07/2023] [Accepted: 06/26/2023] [Indexed: 07/27/2023]
Affiliation(s)
- Kazunari Maekawa
- Department of Pathology, Division of Pathophysiology, Faculty of Medicine, University of Miyazaki, Kiyotake, Miyazaki, Japan
| | - Eiji Nagayasu
- Department of Infectious Diseases, Division of Parasitology, Faculty of Medicine, University of Miyazaki, Kiyotake, Miyazaki, Japan
| | - Youichi Hata
- Department of Surgery, Miyazaki Konan Hospital, Miyazaki, Japan
| | - Fumio Hanamure
- Department of Clinical laboratory, Miyazaki Konan Hospital, Miyazaki, Japan
| | - Haruhiko Maruyama
- Department of Infectious Diseases, Division of Parasitology, Faculty of Medicine, University of Miyazaki, Kiyotake, Miyazaki, Japan
| | - Atsushi Yamashita
- Department of Pathology, Division of Pathophysiology, Faculty of Medicine, University of Miyazaki, Kiyotake, Miyazaki, Japan
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Le TH, Nguyen KT, Pham LTK, Doan HTT, Roan DT, Le XTK, Agatsuma T, Blair D. Mitogenomic and nuclear ribosomal transcription unit datasets support the synonymy of Paragonimus iloktsuenensis and P. ohirai (Paragonimidae: Platyhelminthes). Parasitol Res 2023:10.1007/s00436-023-07854-y. [PMID: 37101088 DOI: 10.1007/s00436-023-07854-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 04/18/2023] [Indexed: 04/28/2023]
Abstract
The complete mitogenome (mtDNA) of nominal Paragonimus iloktsuenensis (Paragonimidae: Trematoda) and the nuclear ribosomal transcription unit (rTU) coding region (rTU*: from 5'-terminus of 18S to 3'-terminus of 28S rRNA gene, excluding the external spacer region) of this species and of P. ohirai were obtained and used to further support the previously suggested synonymy of these taxa in the P. ohirai complex. The complete mitogenome of P. iloktsuenensis was 14,827 bp long (GenBank: ON961029) and nearly identical to that of P. ohirai (14,818 bp; KX765277), with a 99.12% nucleotide identity. The rTU* was 7543 bp and 6932 bp in these two taxa, respectively. All genes and spacers in the rTU were identical in length, with exception of the first internal transcribed spacer, which contained multiple tandem repeat units (6.7 for P. iloktsuenensis and 5.7 for P. ohirai). There was near 100% identity for the rTU genes. The phylogenetic topology inferred from the mtDNA and from individual gene regions (partial cox1 of 387 bp and the ITS-2 of 282 bp - 285 bp) indicated a very close relationship consistent with synonymy of P. iloktsuenensis and P. ohirai. The datasets provided here will be useful for taxonomic reappraisal as well as studies of evolutionary and population genetics of the genus Paragonimus and family Paragonimidae.
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Affiliation(s)
- Thanh Hoa Le
- Immunology Department, Institute of Biotechnology (IBT), Vietnam Academy of Science and Technology (VAST), 18. Hoang Quoc Viet Rd, Cau Giay, Hanoi, Vietnam.
- Graduate University of Science and Technology (GUST), Vietnam Academy of Science and Technology (VAST), 18. Hoang Quoc Viet Rd, Cau Giay, Hanoi, Vietnam.
| | - Khue Thi Nguyen
- Immunology Department, Institute of Biotechnology (IBT), Vietnam Academy of Science and Technology (VAST), 18. Hoang Quoc Viet Rd, Cau Giay, Hanoi, Vietnam
| | - Linh Thi Khanh Pham
- Immunology Department, Institute of Biotechnology (IBT), Vietnam Academy of Science and Technology (VAST), 18. Hoang Quoc Viet Rd, Cau Giay, Hanoi, Vietnam
| | - Huong Thi Thanh Doan
- Immunology Department, Institute of Biotechnology (IBT), Vietnam Academy of Science and Technology (VAST), 18. Hoang Quoc Viet Rd, Cau Giay, Hanoi, Vietnam
- Graduate University of Science and Technology (GUST), Vietnam Academy of Science and Technology (VAST), 18. Hoang Quoc Viet Rd, Cau Giay, Hanoi, Vietnam
| | - Do Thi Roan
- Immunology Department, Institute of Biotechnology (IBT), Vietnam Academy of Science and Technology (VAST), 18. Hoang Quoc Viet Rd, Cau Giay, Hanoi, Vietnam
| | - Xuyen Thi Kim Le
- Immunology Department, Institute of Biotechnology (IBT), Vietnam Academy of Science and Technology (VAST), 18. Hoang Quoc Viet Rd, Cau Giay, Hanoi, Vietnam
| | - Takeshi Agatsuma
- Department of Environmental Health Sciences, Kochi Medical School, Kohasu, Oko-Cho 185-1, Nankoku, Kochi, 783-8505, Japan
| | - David Blair
- College of Science and Engineering, James Cook University, Townsville, QLD, 4811, Australia.
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Zhang Y, Xie Y, Luo Y, Xiang S, Zhong W, Wu N, Chen M, Zhou X, Peng S, Chen Q. Massive secretions in paragonimiasis pleural effusion: a new finding concerning clinical recognition and treatment. Eur J Clin Microbiol Infect Dis 2023; 42:493-501. [PMID: 36826718 DOI: 10.1007/s10096-023-04567-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023]
Abstract
Some paragonimiasis patients in Chongqing, southwest China, have recently exhibited pleural effusions (PEs) with massive viscous secretions. This study aimed to investigate their clinical characteristics, thereby promoting effective treatments. A 3-year retrospective review of paragonimiasis patients who were admitted for nonhomogeneous PEs at Chongqing University Three Gorges Hospital was conducted. Epidemiological data, symptoms, laboratory and imaging findings, treatments, and outcomes were analyzed. Twenty-eight patients were identified, of which 22 (78.6%) were males and 22 (78.6%) were rural residents. Respiratory (85.7%) and constitutional (57.1%) symptoms were common. Paragonimus-specific ELISA was positive in all patients. Eosinophilia was detected in all patients in peripheral blood and PEs. Irregular hyperdense signals were observed in PEs by chest CT scans (96.4%) and ultrasonography (100.0%). Thoracic closed drainage failed in 10 patients (conservative group) because of tube blockage and was eventually replaced by video-assisted thoracoscopic surgery (VATS). Eighteen patients (surgery group) initially underwent VATS, or thoracotomy surgery, without complications. Massive secretions, described as "bean-dregs" or "egg-floccule," were detected intraoperatively, which explained the imaging findings and tube blockage. All patients recovered well after 2-3 courses of postoperative praziquantel treatment. Viscous secretions in paragonimiasis patients warrant great concern. Irregular hyperdense signals in effusions are important characteristics in CT scans and ultrasonography. Treatments such as thoracic closed drainage may fail due to viscous secretions blocking the tube; therefore, surgeries should be considered. In-depth multidisciplinary research may help determine the optimal treatment strategy and reveal the origin of these secretions.
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Affiliation(s)
- Yunxuan Zhang
- Department of Pediatric Surgery, Chongqing University Three Gorges Hospital, Chongqing, 404000, China
- Department of Burn and Plastic Surgery, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Yimin Xie
- Department of Pediatric Surgery, Chongqing University Three Gorges Hospital, Chongqing, 404000, China
| | - Yarui Luo
- Department of Pediatric Surgery, Chongqing University Three Gorges Hospital, Chongqing, 404000, China
| | - Shuang Xiang
- Department of Pathology, Chongqing University Three Gorges Hospital, Chongqing, 404000, China
| | - Wen Zhong
- Department of Medical Imaging, Chongqing University Three Gorges Hospital, Chongqing, 404000, China
| | - Na Wu
- Department of Pediatric Surgery, Chongqing University Three Gorges Hospital, Chongqing, 404000, China
| | - Meng Chen
- Department of Pediatric Surgery, Chongqing University Three Gorges Hospital, Chongqing, 404000, China
| | - Xiaojiao Zhou
- Department of Ultrasonography, Chongqing University Three Gorges Hospital, Chongqing, 404000, China
| | - Shulei Peng
- Department of Sleep Medicine Centre, Chongqing University Three Gorges Hospital, Chongqing, 404000, China.
| | - Qiang Chen
- Department of Pediatric Surgery, Chongqing University Three Gorges Hospital, Chongqing, 404000, China.
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Anisuzzaman, Hossain MS, Hatta T, Labony SS, Kwofie KD, Kawada H, Tsuji N, Alim MA. Food- and vector-borne parasitic zoonoses: Global burden and impacts. ADVANCES IN PARASITOLOGY 2023; 120:87-136. [PMID: 36948728 DOI: 10.1016/bs.apar.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Around 25% of the global population suffer from one or more parasitic infections, of which food- and vector-borne parasitic zoonotic diseases are a major concern. Additionally, zoonoses and communicable diseases, common to man and animals, are drawing increased attention worldwide. Significant changes in climatic conditions, cropping pattern, demography, food habits, increasing international travel, marketing and trade, deforestation, and urbanization play vital roles in the emergence and re-emergence of parasitic zoonoses. Although it is likely to be underestimated, the collective burden of food- and vector-borne parasitic diseases accounts for ∼60 million disability-adjusted life years (DALYs). Out of 20 neglected tropical diseases (NTDs) listed by the World Health Organization (WHO) and the Centres for Disease Control and Prevention (CDC), 13 diseases are of parasitic origin. There are about 200 zoonotic diseases of which the WHO listed eight as neglected zoonotic diseases (NZDs) in the year 2013. Out of these eight NZDs, four diseases, namely cysticercosis, hydatidosis, leishmaniasis, and trypanosomiasis, are caused by parasites. In this review, we discuss the global burden and impacts of food- and vector-borne zoonotic parasitic diseases.
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Affiliation(s)
- Anisuzzaman
- Department of Parasitology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, Bangladesh.
| | - Md Shahadat Hossain
- Department of Parasitology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Takeshi Hatta
- Department of Parasitology and Tropical Medicine, Kitasato University School of Medicine, Minami, Sagamihara, Kanagawa, Japan
| | - Sharmin Shahid Labony
- Department of Parasitology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Kofi Dadzie Kwofie
- Department of Parasitology and Tropical Medicine, Kitasato University School of Medicine, Minami, Sagamihara, Kanagawa, Japan; Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Hayato Kawada
- Department of Parasitology and Tropical Medicine, Kitasato University School of Medicine, Minami, Sagamihara, Kanagawa, Japan
| | - Naotoshi Tsuji
- Department of Parasitology and Tropical Medicine, Kitasato University School of Medicine, Minami, Sagamihara, Kanagawa, Japan.
| | - Md Abdul Alim
- Department of Parasitology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, Bangladesh
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Kang SA, Patel PK, Patil S, Bran-Acevedo A, Layfield L, Wiesemann S, Roland W. A Case of Spontaneous Pneumothorax due to Paragonimiasis in North America with Literature Review. IDCases 2023; 32:e01742. [PMID: 36968306 PMCID: PMC10034413 DOI: 10.1016/j.idcr.2023.e01742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/05/2023] [Indexed: 03/11/2023] Open
Abstract
The species, Paragonimus kellicotti , causes human paragonimiasis in North America. As a foodborne disease, human infection with P. kellicotti occurs after eating raw or undercooked crayfish containing metacercariae. Many risk factors have been described in the literature, including young adult age, male, alcohol consumption, outdoor activities involving rivers within Missouri, and ingesting raw or partially cooked crayfish. Here, we report a case of a 41-year-old male with a 5-year history of cough who presented with acute shortness of breath. Further workup showed mild eosinophilia and spontaneous pneumothorax. A definitive diagnosis was made with a lung biopsy, which showed P. kellicotti eggs. Further questioning revealed that the patient took a hunting and river rafting trip on a river in Missouri 5 years ago, though the history was negative for any crayfish consumption. Paragonimiasis should be considered in those with associated clinical features, including cough and eosinophilia, with a history of a river raft float trip in Missouri, even if the history is negative for crayfish ingestion or travel.
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Affiliation(s)
- Seung Ah Kang
- M4 Medical student, University of Missouri School of Medicine, Columbia, USA
- University of Missouri Hospital and clinic, 1 Hospital Dr, Columbia, MO 65212, USA
| | - Parag Kumar Patel
- Department of Medicine, Division of Infectious Diseases, University of Missouri, Columbia, USA
- University of Missouri Hospital and clinic, 1 Hospital Dr, Columbia, MO 65212, USA
| | - Sachin Patil
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Missouri, Columbia, USA
- University of Missouri Hospital and clinic, 1 Hospital Dr, Columbia, MO 65212, USA
- Correspondence to: Division of Pulmonary, Critical Care and Environmental Medicine, USA.
| | - Andres Bran-Acevedo
- Department of Medicine, Division of Infectious Diseases, University of Missouri, Columbia, USA
- University of Missouri Hospital and clinic, 1 Hospital Dr, Columbia, MO 65212, USA
| | - Lester Layfield
- Department of Pathology and Anatomical Sciences, University of Missouri, Columbia, USA
- University of Missouri Hospital and clinic, 1 Hospital Dr, Columbia, MO 65212, USA
| | - Sebastian Wiesemann
- Department of Cardiothoracic Surgery, University of Missouri, Columbia, USA
- University of Missouri Hospital and clinic, 1 Hospital Dr, Columbia, MO 65212, USA
| | - William Roland
- Department of Medicine, Division of Infectious Diseases, University of Missouri, Columbia, USA
- University of Missouri Hospital and clinic, 1 Hospital Dr, Columbia, MO 65212, USA
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A Cluster of Paragonimiasis with Delayed Diagnosis Due to Difficulty Distinguishing Symptoms from Post-COVID-19 Respiratory Symptoms: A Report of Five Cases. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59010137. [PMID: 36676761 PMCID: PMC9862018 DOI: 10.3390/medicina59010137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/24/2022] [Accepted: 01/09/2023] [Indexed: 01/13/2023]
Abstract
Paragonimiasis caused by trematodes belonging to the genus Paragonimus is often accompanied by chronic respiratory symptoms such as cough, the accumulation of sputum, hemoptysis, and chest pain. Prolonged symptoms, including respiratory symptoms, after coronavirus disease 2019 infection (COVID-19) are collectively called post-COVID-19 conditions. Paragonimiasis and COVID-19 may cause similar respiratory symptoms. We encountered five cases of paragonimiasis in patients in Japan for whom diagnoses were delayed due to the initial characterization of the respiratory symptoms as a post-COVID-19 condition. The patients had consumed homemade drunken freshwater crabs together. One to three weeks after consuming the crabs, four of the five patients were diagnosed with probable COVID-19. The major symptoms reported included cough, dyspnea, and chest pain. The major imaging findings were pleural effusion, pneumothorax, and nodular lesions of the lung. All the patients were diagnosed with paragonimiasis based on a serum antibody test and peripheral blood eosinophilia (560-15,610 cells/μL) and were treated successfully with 75 mg/kg/day praziquantel for 3 days. Before diagnosing a post-COVID-19 condition, it is necessary to consider whether other diseases, including paragonimiasis, may explain the symptoms. Further, chest radiographic or blood tests should be performed in patients with persistent respiratory symptoms after being infected with COVID-19 to avoid overlooking the possibility of infection.
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Sakakura S, Yamaguchi F, Abe T, Cho H, Shimizu S, Mase A, Shikama Y, Maruyama H. Pneumothorax with Eosinophilia is an Important Diagnostic Clue for Distinguishing Paragonimiasis from Chronic Eosinophilic Pneumonia: A Case Report. Infect Drug Resist 2023; 16:2429-2432. [PMID: 37138842 PMCID: PMC10149771 DOI: 10.2147/idr.s402392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/13/2023] [Indexed: 05/05/2023] Open
Abstract
The Paragonimus westermani infection is a parasitic foodborne infection that induces systemic symptoms with eosinophilia in humans. Here, we described pneumothorax in addition to pulmonary opacities with eosinophilia in a man with a positive P. westermani serology. He was misdiagnosed with chronic eosinophilic pneumonia (CEP) during the initial phase. Paragonimiasis can share similar clinical findings with CEP in cases where the worm is confined to the lungs. The findings of the current study suggest that paragonimiasis and CEP can be distinguished from each other by the presence of various symptoms. Notably, eosinophilia with pneumothorax should be an important diagnostic factor for paragonimiasis.
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Affiliation(s)
- Shunsuke Sakakura
- Department of Respiratory Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Fumihiro Yamaguchi
- Department of Respiratory Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
- Correspondence: Fumihiro Yamaguchi, Department of Respiratory Medicine, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama, 227-8501, Japan, Tel +81-45-971-1151, Email
| | - Takashi Abe
- Department of Respiratory Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Hidekazu Cho
- Department of Respiratory Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Shohei Shimizu
- Department of Respiratory Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Ayaka Mase
- Department of Respiratory Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Yusuke Shikama
- Department of Respiratory Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Haruhiko Maruyama
- Division of Parasitology, Department of Infectious Diseases, Graduate School of Medicine and Veterinary Medicine, University of Miyazaki, Miyazaki, Japan
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Al-Tawfiq JA, Kim H, Memish ZA. Parasitic lung diseases. Eur Respir Rev 2022; 31:31/166/220093. [DOI: 10.1183/16000617.0093-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 08/20/2022] [Indexed: 12/02/2022] Open
Abstract
Parasitic lung diseases are caused by a number of parasites as a result of transient passage in the lung or as a result of an immunologic reaction. The clinical presentation may be in the form of focal or cystic lesions, pleural effusion or diffuse pulmonary infiltrates. With increasing globalisation, it is important to consider parasitic infections in the differential diagnosis of lung diseases. This is particularly important since early identification and prompt therapy result in full cure of these conditions. In this review, we summarise the most common parasitic lung diseases.
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Dubey J. Endemic Paragonimus kellicotti infections in animals and humans in USA and Canada: Review and personal perspective. Food Waterborne Parasitol 2022; 30:e00184. [PMID: 36588917 PMCID: PMC9801091 DOI: 10.1016/j.fawpar.2022.e00184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022] Open
Abstract
Infections with the lung fluke, Paragonimus kellicotti, have been diagnosed in a variety of domestic and wild animals and humans in USA and Canada. Although there are many species of Paragonimus in other parts of the world; P. kellicotti is the only species definitively diagnosed in USA and Canada. Fresh water snails (several species) and crayfish (mainly Orconectes spp.) are its intermediate hosts. Humans and animals become infected with P. kellicotti only by ingesting metacercariae encysted in the heart of crayfish. After ingestion, the fluke penetrates intestinal wall, enters peritoneal cavity, and reaches pleural cavity by direct penetration of diaphragm, 2-3 weeks post inoculation (p.i.). Young flukes penetrate lungs and become encysted in pulmonary tissue, often in pairs. Time to maturity is around 4-7 weeks p.i. Eggs are coughed up, swallowed, and are excreted in feces. Although the parasite has been known for more than a century, there has been an upsurge of human infections in the USA. Here, I review P. kellicotti infections in naturally infected hosts. Pathogenesis, diagnosis, and treatment in parasite-free cats and dogs experimentally infected P. kellicotti are reviewed to shed light on the pathogenesis of human paragonimiasis. Problems and challenges facing diagnosis of paragonimiasis, especially non-pulmonary infections, are discussed. Fluke stages are deposited in Smithsonian Museum.
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Voronova AN, Vainutis KS, Tabakaeva TV, Sapotsky MV, Kakareka NN, Volkov YG, Galkina IV, Shchelkanov MY. Molecular identification of the trematode P. ichunensis stat. n. from lungs of siberian tigers justified reappraisal of Paragonimus westermani species complex. J Parasit Dis 2022; 46:744-753. [PMID: 36091260 PMCID: PMC9458828 DOI: 10.1007/s12639-022-01481-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 03/07/2022] [Indexed: 10/18/2022] Open
Abstract
Flukes from the genus Paragonimus Braun, 1899 are medically important foodborne trematodes predominantly occurring throughout Asian countries. Providing molecular genetic characteristics based on ITS2 and partial 28 S rDNA of the paragonimids from the Russian Far East, Northeast, South, and Southeast Asian countries, we performed a partial reappraisal of Paragonimus westermani species complex. Members of this complex are genetically distinct worms with different divergence times and explosive expansion during Miocene-Pliocene epochs. We confirm the taxonomic status as valid species for P. ichunensis stat. n. (from the Russian Far East and Northern China), and P. filipinus (from the Philippines), which were previously considered subspecies of P. westermani, and reinstated the species name P. pulmonalis (from Japan). We suggest considering the worms from South Korea the Korean variety of P. ichunensis, because Korean specimens are sister and genetically closest to P. ichunensis from Northeast China and Primorsky region of Russia. Worms from South (India (type 2), Sri Lanka), Southeast (Malaysia, Vietnam, Thailand (types 1 and 2)) and East Asia (Taiwan) were left in the paragonimid systematics as Paragonimus sp. We propose to consider Indian worms of type 1 as true P. westermani, but in further revisions, due to the lack of holotype and unknown exact type locality, new type specimens (neotype) should be established.
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Affiliation(s)
- Anastasia N. Voronova
- G.P. Somov Institute of Epidemiology and Microbiology, Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, 1, Selskaya st, 690087 Vladivostok, Russia
| | - Konstantin S. Vainutis
- G.P. Somov Institute of Epidemiology and Microbiology, Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, 1, Selskaya st, 690087 Vladivostok, Russia
| | - Tatiana V. Tabakaeva
- G.P. Somov Institute of Epidemiology and Microbiology, Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, 1, Selskaya st, 690087 Vladivostok, Russia
- Far Eastern Federal University, Sukhanova st., 8, 690091 Vladivostok, Russia
| | - Mikhail V. Sapotsky
- Federal Scientific Centre of the East Asia Terrestrial Biodiversity, Far Eastern Branch of the Russian Academy of Sciences, pr. Stoletiya Vladivostoka, 159, 690022 Vladivostok, Russia
| | - Nadezhda N. Kakareka
- Federal Scientific Centre of the East Asia Terrestrial Biodiversity, Far Eastern Branch of the Russian Academy of Sciences, pr. Stoletiya Vladivostoka, 159, 690022 Vladivostok, Russia
| | - Yury G. Volkov
- Federal Scientific Centre of the East Asia Terrestrial Biodiversity, Far Eastern Branch of the Russian Academy of Sciences, pr. Stoletiya Vladivostoka, 159, 690022 Vladivostok, Russia
| | - Irina V. Galkina
- Far Eastern Federal University, Sukhanova st., 8, 690091 Vladivostok, Russia
| | - Mikhail Yu. Shchelkanov
- G.P. Somov Institute of Epidemiology and Microbiology, Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, 1, Selskaya st, 690087 Vladivostok, Russia
- Far Eastern Federal University, Sukhanova st., 8, 690091 Vladivostok, Russia
- Federal Scientific Centre of the East Asia Terrestrial Biodiversity, Far Eastern Branch of the Russian Academy of Sciences, pr. Stoletiya Vladivostoka, 159, 690022 Vladivostok, Russia
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Sun L, Zhu M, Zhang L, Peng M, Li C, Wang L, Wang W, Ma Z, Li S, Zeng W, Yin M, Wang W, Chunyu W. Differences in microbiome of healthy Sprague Dawley rats with Paragonimus proliferus infection and potential pathogenic role of microbes in paragonimiasis. Acta Trop 2022; 233:106578. [PMID: 35779592 DOI: 10.1016/j.actatropica.2022.106578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/12/2022] [Accepted: 06/28/2022] [Indexed: 11/24/2022]
Abstract
Paragonimiasis, which is caused by Paragonimus, is considered to be a neglected tropical disease by the World Health Organization. The pathogenicity of Paragonimus mainly manifests as mechanical damage and immunotoxicity caused by adult worms and larvae. However, microbiota associated with Paragonimus and potential disturbance of host microbiota after infection are unknown. Paragonimus proliferus is a rare species, and its successful infection rate in experimental rats is 100%. In the current study, we compared the microbial community in lung tissues, small intestine contents, and fecal samples from Sprague Dawley (SD) rats with and without P. proliferus infection. To determine the impact of P. proliferus on the microbial community in rats, we identified the microbiota in adult worms of P. proliferus via high-throughput sequencing. Results showed dramatic differences in the composition of microbiota in lung tissues between infected and uninfected rats. Paragonimus metacercariae introduced both environmental and gut microbes into the lung tissues of rats. Many potentially pathogenic microbes were also found in the lung of infected rats. Paragonimus infection increased the chances of potentially pathogenic microbiota invading and colonizing the lungs. However, for the purpose of long-term parasitism, there might be a complex interrelationship between Paragonimus and microorganisms. Our study might shed lights on the understanding of the pathogenicity of Paragonimus.
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Affiliation(s)
- Le Sun
- Department of Pathogen Biology and Immunology, School of Basic Medicine, Kunming Medical University, Kunming, Yunnan 650500, China
| | - Min Zhu
- Department of Pathogen Biology and Immunology, School of Basic Medicine, Kunming Medical University, Kunming, Yunnan 650500, China; Department of Clinical Laboratory, Jiangyou People's Hospital, Mianyang, Sichuan 621700, China
| | - Lei Zhang
- Department of Pathogen Biology and Immunology, School of Basic Medicine, Kunming Medical University, Kunming, Yunnan 650500, China
| | - Man Peng
- Department of Pathogen Biology and Immunology, School of Basic Medicine, Kunming Medical University, Kunming, Yunnan 650500, China
| | - Cuiying Li
- Department of Pathogen Biology and Immunology, School of Basic Medicine, Kunming Medical University, Kunming, Yunnan 650500, China
| | - Liming Wang
- Department of Pathogen Biology and Immunology, School of Basic Medicine, Kunming Medical University, Kunming, Yunnan 650500, China
| | - Weiqun Wang
- Department of Pathogen Biology and Immunology, School of Basic Medicine, Kunming Medical University, Kunming, Yunnan 650500, China
| | - Zhiqiang Ma
- Department of Pathogen Biology and Immunology, School of Basic Medicine, Kunming Medical University, Kunming, Yunnan 650500, China; The Third People's Hospital of Kunming, Kunming, Yunnan 650043, China
| | - Shenghao Li
- Department of Pathogen Biology and Immunology, School of Basic Medicine, Kunming Medical University, Kunming, Yunnan 650500, China; The Third People's Hospital of Kunming, Kunming, Yunnan 650043, China
| | - Weilin Zeng
- Department of Pathogen Biology and Immunology, School of Basic Medicine, Kunming Medical University, Kunming, Yunnan 650500, China
| | - Min Yin
- School of Medicine, Yunnan University, 2 North Cui Hu Road, Kunming, Yunnan 650091, China.
| | - Wenlin Wang
- Department of Pathogen Biology and Immunology, School of Basic Medicine, Kunming Medical University, Kunming, Yunnan 650500, China.
| | - Weixun Chunyu
- Department of Pathogen Biology and Immunology, School of Basic Medicine, Kunming Medical University, Kunming, Yunnan 650500, China.
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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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Endemic Thoracic Infections in Latin America and the Caribbean. Radiol Clin North Am 2022; 60:429-443. [DOI: 10.1016/j.rcl.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Cong CV, Anh TTT, Ly TT, Duc NM. Paragonimiasis diagnosed by CT-guided transthoracic lung biopsy: Literature review and case report. Radiol Case Rep 2022; 17:1591-1597. [PMID: 35309377 PMCID: PMC8927937 DOI: 10.1016/j.radcr.2022.02.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 02/14/2022] [Accepted: 02/14/2022] [Indexed: 11/30/2022] Open
Abstract
More than 40 different species of the parasitic flatworm Paragonimus have been identified worldwide, including in Vietnam, but only 10 species are known to cause disease in humans, particularly Paragonimus westermani. Paragonimus are transmitted through the ingestion of raw foods, especially freshwater shrimp, and crab. Paragonimiasis causes pneumonia, which can present as acute or chronic, with symptoms including prolonged cough, chest pain, shortness of breath, and hemoptysis. Hematologic changes include eosinophilia and the presence of specific antibodies for Paragonimus in the blood. Diagnosis is confirmed when Paragonimus specimens or eggs are found in the sputum or pleural fluid. The specificity of imaging is not high, but imaging can be used to guide the diagnosis. After the failure of microbiological diagnostic methods, lung biopsy can be used to confirm a diagnosis of paragonimiasis. We present a paragonimiasis case associated with unique features, including epidemiologic factors, atypical clinical signs, no increases in blood eosinophils, and negative microbiological tests. Although the patient was suspected of tuberculosis or lung cancer, imaging studies were consistent with the presence of lung flukes. Three transthoracic lung biopsies were performed, and pathology revealed a cystic structure containing Paragonimus on the third biopsy.
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Affiliation(s)
- Cung-Van Cong
- Department of Radiology, National Lung Hospital, Ha Noi, Vietnam
| | | | - Tran-Thi Ly
- Center of Training and Direction of Healthcare Activities, National Lung Hospital, Ha no, Vietnam
- Corresponding authors.
| | - Nguyen Minh Duc
- Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh, Vietnam
- Corresponding authors.
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22
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Abstract
The title of this article refers to Table 1 in Zhou (2022, Infectious diseases of poverty: progress achieved during the decade gone and perspectives for the future. Infectious Diseases of Poverty 11, 1), in which it is indicated that Paragonimus species, like many other foodborne trematodes, are ancient pathogens that are also re-emerging to cause disease in modern times. This article provides a general overview of Paragonimus species and the disease they cause. This is followed by comments on several specific topics of current interest: taxonomy and distribution of members of the genus; details of the life cycle; global and regional prevalence of paragonimiasis; genomics of lung flukes and possible effects of global environmental change. Unresolved questions relating to these topics are discussed and gaps in knowledge identified.
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Shu QH, Li SD, Tian M, Meng Y, He SMQ, Zhu M, Wang MM, Wang WL. Morphological and Molecular Characterization of Paragonimus skrjabini Complex from Yunnan, China: A Brief Report. Acta Parasitol 2022; 67:316-321. [PMID: 34417714 PMCID: PMC8938381 DOI: 10.1007/s11686-021-00461-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 08/04/2021] [Indexed: 11/18/2022]
Abstract
Purpose To perform environmental sampling and molecular identification of Paragonimus in endemic regions, which may help in minimizing transmission among humans. Methods Mountain crabs from the genus Potamiscus were collected and the encysted metacercariae were extracted and subjected to morphological identification, followed by animal inoculation in Sprague–Dawley (SD) rats. After 112 days of infection, animals were killed and adult worms were extracted from lungs and muscles. The morphology of adult worms was characterized by microscopy and molecular identification was done by polymerase chain reaction, followed by sequencing of cox1 and ITS2 genes. Phylogenetic analysis was done by maximum parsimony method. Results A total of 447 crabs were captured from the streams of Tongchang Town, Jinping County, Yunnan Province, China. The infection rate was found to be 41% (186 out of 447 crabs). The metacercariae of Paragonimus skrjabini was identified by the characteristics round or spherical encysted form measuring 410 to 460 × 400 to 460 µm. After animal infection in SD rats, adults were presumptively confirmed to be P. skrjabini, which was also confirmed by gene amplification and sequence analysis of cox1 and ITS2 regions. Paragonimus skrjabini clustered with previously reported P. skrjabini from Yunnan and Vietnam. The confidence values of their branches were > 95%. Phylogenetic analysis of the ITS2 region revealed two distinct clusters with distinct geographical grouping. Phylogenetic analysis with the combined data sets reiterated the geographical grouping with P. skrjabini from Yunnan clustering with strains from Vietnam. Conclusion Metacercariae of P. skrjabini was discovered in freshwater crabs in Yunnan province, China, and the strains were phylogenetically related to P. skrjabini from Vietnam.
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Ishida M, Kaneko C, Irie T, Maruyama Y, Tokuda A, Yoshida A. Sporadic endemicity of zoonotic Paragonimus in raccoon dogs and Japanese badgers from Miyazaki Prefecture, Japan. J Vet Med Sci 2022; 84:454-456. [PMID: 35110459 PMCID: PMC8983277 DOI: 10.1292/jvms.21-0573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Paragonimiasis is a zoonotic trematode infection caused by Paragonimus spp. To determine the recent status of Paragonimus infections in wild animals, this
study investigated Paragonimus spp. in 39 raccoon dogs and 54 Japanese badgers from March 2019 to January 2021 in Miyazaki Prefecture, and examined metacercariae in
freshwater crabs. Triploid P. westermani was found in one raccoon dog (2.6%), and metacercariae were recovered from Eriocheir japonica captured near the
infected animal collected. One Japanese badger (1.9%) harbored P. skrjabini miyazakii; this prevalence was lower than the approximately 30% that was reported in the 1970s.
Results indicated that zoonotic Paragonimus was sporadically prevalent in wild animals. Further investigation in various animals is awaited to elucidate current wildlife
reservoirs for those Paragonimus.
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Affiliation(s)
- Mari Ishida
- Laboratory of Veterinary Parasitic Diseases, Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki
| | - Chiho Kaneko
- Center for Animal Disease Control, University of Miyazaki
| | - Takao Irie
- Laboratory of Veterinary Parasitic Diseases, Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki.,Center for Animal Disease Control, University of Miyazaki
| | - Yoshino Maruyama
- Laboratory of Veterinary Parasitic Diseases, Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki
| | - Asami Tokuda
- Laboratory of Veterinary Parasitic Diseases, Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki
| | - Ayako Yoshida
- Laboratory of Veterinary Parasitic Diseases, Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki.,Center for Animal Disease Control, University of Miyazaki
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Morphological and Molecular Characterization of Paragonimus Species Isolated from Freshwater Crabs in Southern Yunnan, China. J Trop Med 2022; 2021:5646291. [PMID: 35003270 PMCID: PMC8741392 DOI: 10.1155/2021/5646291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 11/12/2021] [Accepted: 11/16/2021] [Indexed: 11/18/2022] Open
Abstract
Paragonimus species are highly prevalent in various regions of China. The study's objective is to isolate and identify Paragonimus from natural habitats and compare the phylogenetic diversity of Paragonimus in southern Yunnan province, China. Metacercariae of Paragonimus was isolated from crabs, and morphologic identification was performed by microscopy. Metacercariae were injected into experimental Paragonimus free Sprague Dawley rats. After 114 days, adult worms and eggs were isolated from multiple organs. Morphologic identification confirmed the initial identification. DNA was extracted from 5 adult worms, and molecular characterization was performed by amplification and sequencing of CO1 and ITS2 regions, followed by phylogenetic analysis. Out of 447 crabs captured, 186 crabs were found to be infected. A total of 4 species of Paragonimus was observed from naturally infected crabs. Paragonimus microrchis (2), Paragonimus heterotremus (1), Paragonimus proliferus (1), and Paragonimus skrjabini (1) were isolated and identified. A total of 32 sequences were downloaded from the National Center for Biotechnology Information, and 5 sequences generated in the study were used for phylogenetic analysis. In the phylogenetic tree of the CO1 gene, Paragonimus proliferus, Paragonimus heterotremus, and Paragonimus skrjabini were clustered with the same species, and the confidence values of their branches were >95%. A congruent phylogenetic relationship was observed with the ITS2 phylogenetic tree. In the phylogenetic tree constructed with the combined dataset of CO1 and ITS2 datasets, Paragonimus proliferus, Paragonimus heterotremus, and Paragonimus skrjabini clustered with the same species, and their branch confidence values were >94%. Paragonimus microrchis clustered with Paragonimus bangkokensis in both datasets. Phylogenetic analysis revealed robustness of the double loci method as against the single-locus method with either CO1 or ITS2 alone. Paragonimus species isolated from the southern Yunnan province, China, was phylogenetically diverse, and the analysis revealed the clustering of multiple species of Paragonimus isolated from different geographic locations.
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Sripa B, Leonardo L, Hong SJ, Ito A, Brattig NW. Status and perspective of asian neglected tropical diseases. Acta Trop 2022; 225:106212. [PMID: 34687645 DOI: 10.1016/j.actatropica.2021.106212] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 01/09/2023]
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Mathison BA, Sapp SGH. An annotated checklist of the eukaryotic parasites of humans, exclusive of fungi and algae. Zookeys 2021; 1069:1-313. [PMID: 34819766 PMCID: PMC8595220 DOI: 10.3897/zookeys.1069.67403] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 08/20/2021] [Indexed: 12/13/2022] Open
Abstract
The classification of "parasites" in the medical field is a challenging notion, a group which historically has included all eukaryotes exclusive of fungi that invade and derive resources from the human host. Since antiquity, humans have been identifying and documenting parasitic infections, and this collective catalog of parasitic agents has expanded considerably with technology. As our understanding of species boundaries and the use of molecular tools has evolved, so has our concept of the taxonomy of human parasites. Consequently, new species have been recognized while others have been relegated to synonyms. On the other hand, the decline of expertise in classical parasitology and limited curricula have led to a loss of awareness of many rarely encountered species. Here, we provide a comprehensive checklist of all reported eukaryotic organisms (excluding fungi and allied taxa) parasitizing humans resulting in 274 genus-group taxa and 848 species-group taxa. For each species, or genus where indicated, a concise summary of geographic distribution, natural hosts, route of transmission and site within human host, and vectored pathogens are presented. Ubiquitous, human-adapted species as well as very rare, incidental zoonotic organisms are discussed in this annotated checklist. We also provide a list of 79 excluded genera and species that have been previously reported as human parasites but are not believed to be true human parasites or represent misidentifications or taxonomic changes.
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Affiliation(s)
- Blaine A. Mathison
- Institute for Clinical and Experimental Pathology, ARUP Laboratories, Salt Lake City, UT, USAInstitute for Clinical and Experimental PathologySalt Lake CityUnited States of America
| | - Sarah G. H. Sapp
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USACenters for Disease Control and PreventionAtlantaUnited States of America
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Ai L, Li J, Ye T, Wang W, Li Y. Exudative pleural effusion caused by lung fluke infection: case report. Int J Infect Dis 2021; 114:175-177. [PMID: 34758390 DOI: 10.1016/j.ijid.2021.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 11/01/2021] [Accepted: 11/02/2021] [Indexed: 10/19/2022] Open
Abstract
The global incidence of lung fluke disease is low, and the infection is a rare cause of pleural effusion in adults. This article reports a case of exudative pleural effusion accompanied by eosinophilia in a 19-year-old male which was finally proven to be caused by lung fluke infection through antibody testing. This case highlights that lung fluke infection is an easily overlooked cause of pleural effusion. Eosinophilia is a potential marker of infection, and serological tests could further confirm the diagnosis.
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Affiliation(s)
- Ling Ai
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Jingyuan Li
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Ting Ye
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Wenjun Wang
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Yuying Li
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
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Zhou XJ, Yang Q, Tan QH, Zhang LY, Shi LB, Zou JX. Paragonimus and its hosts in China: An update. Acta Trop 2021; 223:106094. [PMID: 34389330 DOI: 10.1016/j.actatropica.2021.106094] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/30/2021] [Accepted: 07/30/2021] [Indexed: 11/17/2022]
Abstract
Paragonimiasis is an important foodborne parasitic disease. Over 50 species of Paragonimus have been reported worldwide, and China has the widest distribution and largest number of species. The detection of Paragonimus metacercariae from second intermediate hosts has been reported in 22 provinces and municipalities. The most frequently reported species are P. westermani, P. skrjabini, P. heterotremus and Euparagonimus cenocopiosus. In this review, we collected and reviewed relevant reports on the detection of Paragonimus metacercariae in second intermediate hosts from 1937 to 2020 from all areas of China. We provide an updated and current summary of Paragonimus species and their hosts in China. Data on the geographical range, species distribution, and second intermediate host species of Paragonimus were extracted. ArcGIS10.2 software was used to generate distribution maps of Paragonimus for four time periods: 1937-1990, 1991-2005, 2006-2020 and 1937-2020. We analyzed the geographic and spatiotemporal dynamics of Paragonimus prevalence in natural foci and provided a basis for further research and paragonimiasis prevention strategies in China.
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Affiliation(s)
- Xiao-Juan Zhou
- Research lab of Freshwater Crustacean Decapoda & Paragonimus, School of Basic Medical Sciences, Nanchang University, Nanchang, Jiangxi, PR China.
| | - Qian Yang
- Research lab of Freshwater Crustacean Decapoda & Paragonimus, School of Basic Medical Sciences, Nanchang University, Nanchang, Jiangxi, PR China.
| | - Qi-Hong Tan
- Research lab of Freshwater Crustacean Decapoda & Paragonimus, School of Basic Medical Sciences, Nanchang University, Nanchang, Jiangxi, PR China.
| | - Li-Yanyang Zhang
- Research lab of Freshwater Crustacean Decapoda & Paragonimus, School of Basic Medical Sciences, Nanchang University, Nanchang, Jiangxi, PR China.
| | - Lin-Bo Shi
- Department of Parasitology, School of Basic Medical Sciences, Nanchang University, Nanchang, Jiangxi, PR China.
| | - Jie-Xin Zou
- Research lab of Freshwater Crustacean Decapoda & Paragonimus, School of Basic Medical Sciences, Nanchang University, Nanchang, Jiangxi, PR China; Department of Parasitology, School of Basic Medical Sciences, Nanchang University, Nanchang, Jiangxi, PR China.
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30
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Izzati UZ, Kaneko Y, Kaneko C, Yoshida A, Suwanruengsri M, Okabayashi T, Hirai T, Yamaguchi R. Distribution of Pseudorabies Virus Antigen in Hunting Dogs with Concurrent Paragonimus westermani Infection. J Comp Pathol 2021; 188:44-51. [PMID: 34686277 DOI: 10.1016/j.jcpa.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/28/2021] [Accepted: 08/22/2021] [Indexed: 11/25/2022]
Abstract
Following isolation of pseudorabies virus (PRV) from two hunting dogs in Oita prefecture, Japan, we investigated the PRV antigen distribution in the tissues of the infected animals. At necropsy, PRV-associated lesions included facial oedema, tonsillar and meningeal congestion, blotchy haemorrhages on the pericardium and mitral valves, and incomplete splenic contraction in one dog, with less prominent findings in the other dog. Multiple pulmonary nodules were seen in both cases, caused by the diploid form of Paragonimus westermani lung flukes, as confirmed by PCR-restriction fragment length polymorphism and gene sequencing analyses. Histological examination revealed that the PRV infection was associated with lesions of non-suppurative encephalitis in the brainstem. PRV antigen was detected in the cerebrum, cerebellum, brainstem, submucosal and myenteric plexuses, and mononuclear cells, mainly in the bone marrow, lymph nodes, tonsils and spleen tissues. There was evidence of PRV dissemination to the brain via the trigeminal or olfactory routes, in addition to possible spread to lymphoid organs via infected mononuclear cells.
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Affiliation(s)
- Uda Z Izzati
- Department of Veterinary Pathology, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan
| | - Yasuyuki Kaneko
- Teaching Hospital, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan
| | - Chiho Kaneko
- Centre for Animal Disease Control, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan
| | - Ayako Yoshida
- Department of Parasitology, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan
| | - Mathurot Suwanruengsri
- Department of Veterinary Pathology, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan
| | - Tamaki Okabayashi
- Centre for Animal Disease Control, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan
| | - Takuya Hirai
- Department of Veterinary Pathology, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan
| | - Ryoji Yamaguchi
- Department of Veterinary Pathology, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan.
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31
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Urabe M, Marcaida AJB. A record of juvenile Paragonimus skrjabini miyazakii from the urinary bladder of the Japanese toad, Bufo japonicus formosus. Parasitol Int 2021; 86:102474. [PMID: 34597760 DOI: 10.1016/j.parint.2021.102474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/20/2021] [Accepted: 09/24/2021] [Indexed: 10/20/2022]
Abstract
We found juveniles of Paragonimus in the urinary bladder of a Japanese toad (Bufo japonicus formosus) captured in Kyoto. These were molecularly identified as Paragonimus skrjabini miyazakii Kamo, Nishida, Hatsushika et Tomimura 1961. This is the first report of P. s. miyazakii found in anuran hosts in Japan, indicating that anurans can be paratenic hosts of P. s. miyazakii, as is also the case for Paragonimus skrjabini skrjabini in China. This finding suggests that definitive hosts of P. s. miyazakii can be infected by eating not only crabs or mammal paratenic hosts, but also anurans.
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Affiliation(s)
- Misako Urabe
- Department of Ecosystem Studies, Faculty of Environmental Science, The University of Shiga Prefecture, Shiga 522-8533, Japan.
| | - Arvin Jet B Marcaida
- Division of Environmental Dynamics, Graduate School of Environmental Science, The University of Shiga Prefecture, Shiga 522-8533, Japan
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Lee JH, Kang SY, Yoo Y, An J, Park SY, Lee JH, Lee SE, Kim MH, Kanemitsu Y, Chang YS, Song WJ. Epidemiology of adult chronic cough: disease burden, regional issues, and recent findings. Asia Pac Allergy 2021; 11:e38. [PMID: 34786368 PMCID: PMC8563099 DOI: 10.5415/apallergy.2021.11.e38] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 12/12/2022] Open
Abstract
Chronic cough is a common medical condition that has a significant impact on patients' quality of life. Although it was previously considered a symptom of other disorders, it is now regarded as a pathologic state that is characterized by a deviation from the intrinsic protective functions of the cough reflex, especially in adults. There are several factors that may underlie the cough reflex hypersensitivity and its persistence, such as age, sex, comorbidities, viral infection, exposure to irritants or environmental pollutants, and their interactions may determine the epidemiology of chronic cough in different countries. With a deeper understanding of disease pathophysiology and advanced research methodology, there are more attempts to investigate cough epidemiology using a large cohort of healthcare population data. This is a narrative overview of recent findings on the disease burden, risk factors, Asia-Pacific issues, and longitudinal outcomes in adults with chronic cough. This paper also discusses the approaches utilizing routinely collected data in cough research.
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Affiliation(s)
- Ji-Hyang Lee
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Yoon Kang
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Youngsang Yoo
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Gangneung Asan Hospital, Gangneung, Korea
| | - Jin An
- Department of Allergy, Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
| | - So-Young Park
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Ji-Ho Lee
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Seung-Eun Lee
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Min-Hye Kim
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Yoshihiro Kanemitsu
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Yoon-Seok Chang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Woo-Jung Song
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Chelomina GN, Kukla SP, Chelomin VP, Doanh PN. Genotoxicity of Paragonimus heterotremus Infection in a Rat Model of Simultaneous Pulmonary and Hepatic Paragonimiasis. Biomedicines 2021; 9:biomedicines9091180. [PMID: 34572365 PMCID: PMC8469942 DOI: 10.3390/biomedicines9091180] [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: 08/06/2021] [Revised: 09/01/2021] [Accepted: 09/06/2021] [Indexed: 11/16/2022] Open
Abstract
Parasites cause numerous health issues in humans, eventually leading to significant social and economic damage; however, the mechanisms of parasite-mediated pathogenesis are not well understood. Nevertheless, it is clearly evidenced that cancerogenic fluke-induced chronic inflammations and cancer are closely associated with oxidative stress. (1) Methods: The Paragonimus heterotremus infection’s genotoxic potential was assessed in a rat model of simultaneous pulmonary and hepatic paragonimiasis by the alkaline version of single-cell gel electrophoresis (comet assay). Statistical analysis of comet parameters was based on the non-parametric Mann–Whitney U test. (2) Results: A clear and statistically significant increase in DNA damage was detected in the helminth-exposed group versus the control rats and the tissue areas adjacent to the parasite capsule versus remote ones; however, differences in DNA damage patterns between different tissues were not statistically significant. Infection resulted in up to 40% cells with DNA damage and an increased genetic damage index. (3) Conclusions: The data obtained contribute to understanding the pathogenesis mechanisms of paragonimiasis, suggesting oxidative stress as the most likely reason for DNA breaks; these findings allow us to consider P. heterotremus as a potentially cancerogenic species, and they are important for the monitoring and treatment of paragonimiasis.
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Affiliation(s)
- Galina N. Chelomina
- Federal Scientific Center of the East Asia Terrestrial Biodiversity, Far-Eastern Branch of Russian Academy of Science, Vladivostok 690022, Primorsky Krai, Russia
- Correspondence: (G.N.C.); (S.P.K.)
| | - Sergey P. Kukla
- V. I. Il’ichev Pacific Oceanological Institute, Far East Branch of the Russian Academy of Sciences, Vladivostok 690022, Primorsky Krai, Russia;
- Correspondence: (G.N.C.); (S.P.K.)
| | - Viktor P. Chelomin
- V. I. Il’ichev Pacific Oceanological Institute, Far East Branch of the Russian Academy of Sciences, Vladivostok 690022, Primorsky Krai, Russia;
| | - Pham N. Doanh
- Institute of Ecology and Biological Resources, Graduate University of Sciences and Technology, Vietnam Academy of Science and Technology, Hanoi 100000, Vietnam;
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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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Nagaoka F, Yamazaki T, Akashi-Takamura S, Itoh M. Detection of Urinary Antibodies and Its Application in Epidemiological Studies for Parasitic Diseases. Vaccines (Basel) 2021; 9:778. [PMID: 34358194 PMCID: PMC8310028 DOI: 10.3390/vaccines9070778] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/25/2021] [Accepted: 07/06/2021] [Indexed: 01/23/2023] Open
Abstract
For epidemiological studies of infectious diseases, pathogen-specific antibody levels in an area give us essential and appropriate information. The antibodies against pathogens are usually detected in blood, the drawing of which inconveniences people. Collection of blood increases the risk of accidental infections through blood, and it is difficult to obtain the participation of the target populations, especially the younger generation. On the other hand, urine samples, which contain a high enough level of antibodies for ELISA, can be harmlessly and easily collected and therefore have been used for epidemiological studies for diseases. The antibody examination of urine has been used for the epidemiology of parasitic diseases with a high sensitivity and specificity of serum samples. In this paper, we reviewed antibody assays with urine for seven parasitic diseases that urine diagnostic methods have reported in the past, and these are important infections included in NTDs, caused, for example, by Leishmania donovani, Wuchereria bancrofti, Schistosoma japonicum, Paragonimus westermani, Echinococcus granulosus, Echinococcus multilocularis, Strongyloides stercoralis, and Opisthorchis viverrini. The easy and safe urine surveillance system might be an admirable tool for future epidemiological studies for infectious diseases.
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Affiliation(s)
| | | | | | - Makoto Itoh
- Department of Microbiology and Immunology, School of Medicine, Aichi Medical University, Aichi 480-1195, Japan; (F.N.); (T.Y.); (S.A.-T.)
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Jin WX, Li TH, Zhu H, Zhu L. A case of hepatic paragonimiasis was misdiagnosed as hepatocellular carcinoma with rupture and haemorrhage. J Int Med Res 2021; 49:3000605211012668. [PMID: 34098756 PMCID: PMC8191090 DOI: 10.1177/03000605211012668] [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] [Indexed: 12/13/2022] Open
Abstract
Paragonimiasis is a disease caused by parasitic infections that mainly involve the lungs. However, it can also produce ectopic infections, such as when the parasites invade the liver, brain and subcutaneous tissue, which then cause different symptoms. This current case report describes a 55-year-old male patient with hepatic paragonimiasis that was misdiagnosed as liver cancer with rupture and haemorrhage. The initial computed tomography findings suggested ruptured liver cancer. The patient underwent laparoscopic right hemihepatectomy. Postoperative pathological analysis resulted in a diagnosis of hepatic paragonimiasis. The patient recovered well postoperatively and was treated with 25 mg/kg praziquantel orally three times a day for 3 days after discharge with good efficacy. In this present case, the rupture and haemorrhage of the liver mass made it difficult for the treating physicians to consider hepatic paragonimiasis, which lead to the initial misdiagnosis of this patient. Although paragonimiasis is very rare, medical staff should be vigilant and have a comprehensive understanding of the different diseases that can cause liver masses so that misdiagnosis can be avoided.
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Affiliation(s)
- Wen-Xiang Jin
- Department of Hepatobiliary Surgery, Second Clinical College, Kunming Medical University, The Second Affiliated Hospital of Kunming Medical College, Kunming, Yunnan Province, China
| | - Tie-Han Li
- Department of Hepatobiliary Surgery, Kunming Medical University, The Second Affiliated Hospital of Kunming Medical College, Kunming, Yunnan Province, China
| | - Hong Zhu
- Department of Hepatobiliary Surgery, Kunming Medical University, The Second Affiliated Hospital of Kunming Medical College, Kunming, Yunnan Province, China
| | - Lei Zhu
- Department of Hepatobiliary Surgery, Kunming Medical University, The Second Affiliated Hospital of Kunming Medical College, Kunming, Yunnan Province, China
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Shu QH, Yang Y, Li SD, Zhao JS, Li SH, Wang MM, Wang WQ, Tian M, He SMQ, Ma ZQ, Zhu M, Wang WL. Analysis of the misdiagnosis of 8 adult cases of paragonimiasis with lung masses as the main manifestation in Xishuangbanna, Yunnan. J Cardiothorac Surg 2021; 16:28. [PMID: 33741016 PMCID: PMC7977500 DOI: 10.1186/s13019-021-01408-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 03/08/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To summarize the clinical characteristics of adult cases of paragonimiasis with lung masses as the main manifestation in Xishuangbanna, Yunnan Province, analyze the causes of misdiagnosis, and improve the levels of clinical diagnosis and treatment. METHOD We conducted a retrospective analysis of the clinical data and diagnosis and treatment of 8 adult cases of paragonimiasis with lung masses as the main manifestation that were diagnosed in the Oncology Department of People's hospital of Xishuangbanna Dai Autonomous Prefecture from July 2014 to July 2019. RESULT All 8 patients were from epidemic paragonimiasis areas and had a confirmed history of consuming uncooked freshwater crabs. The clinical manifestations were mainly fever, dry cough, and chest pain. The disease durations were long, and peripheral blood eosinophil counts were elevated. The cases had been misdiagnosed as pneumonia or pulmonary tuberculosis. After years of anti-inflammatory or anti-tuberculosis treatment, the symptoms had not improved significantly. Patients eventually sought treatment from the oncology department for hemoptysis. Chest computed tomography showed patchy consolidation in the lungs, with nodules, lung masses, and enlarged mediastinal lymph nodes. CONCLUSION Paragonimiasis is a food-borne parasitic disease. Early clinical manifestations and auxiliary examination results are nonspecific. The parasite most often invades the lungs, and the resulting disease is often misdiagnosed as pneumonia, pulmonary tuberculosis, or lung cancer (Acta Trop 199: 05074, 2019). To avoid misdiagnosis, clinicians should inquire, in detail, about residence history and history of unclean food and exposure to infected water and make an early diagnosis based on the inquired information and imaging examination results. For patients who have been diagnosed with pneumonia or pulmonary tuberculosis and whose symptoms do not improve significantly after anti-inflammatory or anti-tuberculosis treatments, their epidemiological history should be traced to further conduct differential diagnosis and avoid misdiagnosis.
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Affiliation(s)
- Qiu-Hong Shu
- The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, 651010, Yunnan, China
| | - Yang Yang
- Oncology Department, People's hospital of Xishuangbanna Dai Autonomous Prefecture, Xishuangbanna, Jinghong, Yunnan, China
| | - Shu-De Li
- Kunming Medical University, No.1168, Chunrong West Road, Yuhua Street, Chenggong District, Kunming, 65050, Yunnan, China
| | - Jun-Sheng Zhao
- Mengma Town Central Health Center, Menglian, Pu'er City, Yunnan, China
| | - Sheng-Hao Li
- The Third People's Hospital of Kunming, Kunming, China
| | - Miao-Miao Wang
- Kunming Medical University, No.1168, Chunrong West Road, Yuhua Street, Chenggong District, Kunming, 65050, Yunnan, China
| | - Wei-Qun Wang
- Kunming Medical University, No.1168, Chunrong West Road, Yuhua Street, Chenggong District, Kunming, 65050, Yunnan, China
| | - Ming Tian
- Kunming Medical University, No.1168, Chunrong West Road, Yuhua Street, Chenggong District, Kunming, 65050, Yunnan, China
| | - Shu-Mei-Qi He
- The 2nd People's Hospital of Chengdu, No.10, Qingyun South Road, Jinjiang District, Chengdu, 510104, Sichuan Province, China
| | - Zhi-Qiang Ma
- The Third People's Hospital of Kunming, Kunming, China
| | - Min Zhu
- Kunming Medical University, No.1168, Chunrong West Road, Yuhua Street, Chenggong District, Kunming, 65050, Yunnan, China
| | - Wen-Lin Wang
- Kunming Medical University, No.1168, Chunrong West Road, Yuhua Street, Chenggong District, Kunming, 65050, Yunnan, China.
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Al Bishawi A, Salameh S, Ehtesham A, Massad I, Arachchige S, Hatim A, Bozom I, Thapur M. Paragonimus infection: Rare manifestation with pericardial effusion: A Case report and Literature review. IDCases 2021; 24:e01075. [PMID: 33850719 PMCID: PMC8022158 DOI: 10.1016/j.idcr.2021.e01075] [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: 03/02/2021] [Accepted: 03/12/2021] [Indexed: 11/27/2022] Open
Abstract
Background Paragonimus, is a globally distributed trematode, with human disease limited to endemic regions. It can be transmitted to humans through ingestion of intermediate hosts that are crustaceans. Most symptomatic infections consist of pulmonary disease, and in aberrant migration of immature flukes, extrapulmonary manifestations may occur. These presentations are relatively uncommon and may affect various organs with atypical Clinico-radiological pathologies that are often challenging to diagnose. Pericardial involvement has scarcely been reported before. Furthermore, the management, clinical outcomes and potential complications of this involvement remain unclear. Case report Our patient is a 31-year-old Nepalese male who presented with abdominal distension and lower limb oedema. Initial work up revealed pericardial effusion, and analysis was suggestive of exudative lymphocytic effusion. Supported by positive QuantiFERON result along with his demographic data, the patient was treated presumptively as a case of tuberculous pericarditis, despite the negative initial Mycobacterial Tuberculosis work up. During follow up, the patient lacked clinical response and repeated echocardiography showed signs of tamponade with concomitant pleural effusion. subsequently video-assisted-thoracoscopy pericardial window along with pericardial and pleural biopsy were performed. Histopathological examination of the biopsied tissue revealed non-necrotizing granulomas containing a parasitic egg suggestive of Paragonimus. Fortunately, the patient received treatment with praziquantel and subsequently made good clinical recovery. Conclusion Diagnosis of extrapulmonary Paragonimus infection can be challenging given its rarity and clinical picture mimicking other infectious aetiologies. Pericardial involvement is seldom reported in the literature and clinical suspicion should be raised particularly when dealing with atypical presentations and relevant demographic data.
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Affiliation(s)
- Ahmad Al Bishawi
- Hamad Medical Corporation, Department of Internal Medicine - Division of Infectious Diseases, Qatar
| | - Sarah Salameh
- Hamad Medical Corporation, Department of Internal Medicine - Division of Infectious Diseases, Qatar
| | - Ahsan Ehtesham
- Hamad Medical Corporation, Department of Surgery - Division of Cardiothoracic Surgery, Qatar
| | - Ihab Massad
- Hamad Medical Corporation, Department of Surgery - Division of Cardiothoracic Surgery, Qatar
| | - Suresh Arachchige
- Hamad Medical Corporation, Department of Internal Medicine - Division of General Medicine, Qatar
| | - Ahmed Hatim
- Hamad Medical Corporation, Department of Internal Medicine - Division of General Medicine, Qatar
| | - Issam Bozom
- Hamad Medical Corporation, Department of Clinical Laboratory Medicine and Pathology, Qatar
| | - Maliha Thapur
- Hamad Medical Corporation, Department of Internal Medicine - Division of Infectious Diseases, Qatar
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Ning W, Yang L, Chen Y, Chen C. A 48 year old male with wandering pleural effusion and pulmonary infiltration. EUR J INFLAMM 2021. [DOI: 10.1177/2058739220960553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We reported a case of pulmonary paragonimiasis presenting as wandering pleural effusion and pulmonary infiltration. The patient had an explicit history of eating raw freshwater crabs 6 months earlier, and a test for serum antibodies to paragonimus was positive. This case illustrates the complex nature of pathological processes and immunological responses in the lungs and highlights the need to consider the existence of paragonimus infection.
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Affiliation(s)
- Weiwei Ning
- Respiratory Department, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Limin Yang
- Respiratory Department, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yanbin Chen
- Respiratory Department, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Cheng Chen
- Respiratory Department, The First Affiliated Hospital of Soochow University, Suzhou, China
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40
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Tantrawatpan C, Tapdara S, Agatsuma T, Sanpool O, Intapan PM, Maleewong W, Saijuntha W. Genetic differentiation of Southeast Asian Paragonimus Braun, 1899 (Digenea: Paragonimidae) and genetic variation in the Paragonimus heterotremus complex examined by nuclear DNA sequences. INFECTION GENETICS AND EVOLUTION 2021; 90:104761. [PMID: 33577999 DOI: 10.1016/j.meegid.2021.104761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/29/2021] [Accepted: 02/04/2021] [Indexed: 10/22/2022]
Abstract
Southeast Asian lung flukes, the causative agents of human and animal paragonimiasis, comprise at least 14 species. Of these, seven species; Paragonimus bangkokensis, P. harinasutai, P. macrorchis, P. siamensis, P. westermani, P. heterotremus and P. pseudoheterotremus were studied. Two regions of domain 1 of taurocyamine kinase; TkD1 (exon) and TkD1Int2 (intron 2), were used as genetic markers for elucidating their genetic differentiation, genetic variation, and heterozygosity. The TkD1 region was conserved between these species but can potentially be used to differentiate all seven species. However, the TkD1Int2 region had a high level of polymorphism, which is suitable for investigation of genetic variation within or between closely related species, especially P. heterotremus and P. pseudoheterotremus as well as for a phylogenetic analyses of the genus Paragonimus. Heterozygosity was mostly observed in DNA samples extracted from adult P. heterotremus including samples taken from sputum of paragonimiasis patients, whereas DNA extracted from metacercariae was not, except in the samples from Myanmar. Our findings provide evidence of DNA recombination and incomplete lineage sorting of P. heterotremus and P. pseudoheterotremus in TkD1Int2, which suggesting gene flow between these two species.
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Affiliation(s)
- Chairat Tantrawatpan
- Division of Cell Biology, Department of Preclinical Sciences, Faculty of Medicine and Center of Excellence in Stem Cell Research, Thammasat University, Rangsit Campus, Pathum Thani 12120, Thailand
| | - Sumonta Tapdara
- Clinical Pathology Laboratory, Amnatcharoen Hospital, Amnatcharoen 37000, Thailand
| | - Takeshi Agatsuma
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Oko, Nankoku 783-8505, Japan
| | - Oranuch Sanpool
- Department of Parasitology, Faculty of Medicine and Research and Diagnostic Center for Emerging Infectious Diseases, Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Pewpan M Intapan
- Department of Parasitology, Faculty of Medicine and Research and Diagnostic Center for Emerging Infectious Diseases, Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Wanchai Maleewong
- Department of Parasitology, Faculty of Medicine and Research and Diagnostic Center for Emerging Infectious Diseases, Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Weerachai Saijuntha
- Walai Rukhavej Botanical Research Institute, Mahasarakham University, Maha Sarakham 44150, Thailand.
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Abstract
Parasites can cause respiratory symptoms through focal or diffuse lung involvement, depending on the location of the parasite and the host's immune response. Pulmonary involvement can be a major feature of some parasitic infections or a complication during transpulmonary larval migration. Parasites should be included in the differential diagnosis of common lung diseases, especially in the presence of peripheral eosinophilia or extrapulmonary symptoms (abdominal pain, diarrhea, jaundice, skin lesions).
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Affiliation(s)
- Teena Huan Xu
- Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, One Baylor Plaza. BCM 285, Houston, TX 77030, USA
| | - Nair Lovaton
- Department of Pediatrics, Faculty of Medicine, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, Lima 15102, Peru
| | - Jose Serpa
- Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, One Baylor Plaza. BCM 285, Houston, TX 77030, USA
| | - Theresa J Ochoa
- Department of Pediatrics, Faculty of Medicine, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, Lima 15102, Peru.
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Rabone M, Wiethase J, Clark PF, Rollinson D, Cumberlidge N, Emery AM. Endemicity of Paragonimus and paragonimiasis in Sub-Saharan Africa: A systematic review and mapping reveals stability of transmission in endemic foci for a multi-host parasite system. PLoS Negl Trop Dis 2021; 15:e0009120. [PMID: 33544705 PMCID: PMC7891758 DOI: 10.1371/journal.pntd.0009120] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 02/18/2021] [Accepted: 01/09/2021] [Indexed: 11/19/2022] Open
Abstract
Paragonimiasis is caused by zoonotic trematodes of Paragonimus spp., found in Asia, the Americas and Africa, particularly in tropical regions. These parasites have a complex, multi-host life cycle, with mammalian definitive hosts and larval stages cycling through two intermediate hosts (snails and freshwater decapod crustaceans). In Africa, paragonimiasis is particularly neglected, and remains the only human parasitic disease without a fully characterised life cycle. However paragonimiasis has potentially significant impacts on public health in Africa, and prevalence has likely been underestimated through under-reporting and misdiagnosis as tuberculosis due to a similar clinical presentation. We identified the need to synthesise current knowledge and map endemic foci for African Paragonimus spp. together with Poikilorchis congolensis, a rare, taxonomically distant trematode with a similar distribution and morphology. We present the first systematic review of the literature relating to African paragonimiasis, combined with mapping of all reported occurrences of Paragonimus spp. throughout Africa, from the 1910s to the present. In human surveys, numerous reports of significant recent transmission in Southeast Nigeria were uncovered, with high prevalence and intensity of infection. Overall prevalence was significantly higher for P. uterobilateralis compared to P. africanus across studies. The potential endemicity of P. africanus in Côte d'Ivoire is also reported. In freshwater crab intermediate hosts, differences in prevalence and intensity of either P. uterobilateralis or P. africanus were evident across genera and species, suggesting differences in susceptibility. Mapping showed temporal stability of endemic foci, with the majority of known occurrences of Paragonimus found in the rainforest zone of West and Central Africa, but with several outliers elsewhere on the continent. This suggests substantial under sampling and localised infection where potential host distributions overlap. Our review highlights the urgent need for increased sampling in active disease foci in Africa, particularly using molecular analysis to fully characterise Paragonimus species and their hosts.
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Affiliation(s)
- Muriel Rabone
- Department of Life Sciences, Natural History Museum, Cromwell Road, London, United Kingdom
- London Centre for Neglected Tropical Disease Research, School of Public Health, Faculty of Medicine, Imperial College London, Norfolk Place, London, United Kingdom
| | - Joris Wiethase
- Department of Biology, University of York, Wentworth Way, York, United Kingdom
| | - Paul F. Clark
- Department of Life Sciences, Natural History Museum, Cromwell Road, London, United Kingdom
| | - David Rollinson
- Department of Life Sciences, Natural History Museum, Cromwell Road, London, United Kingdom
- London Centre for Neglected Tropical Disease Research, School of Public Health, Faculty of Medicine, Imperial College London, Norfolk Place, London, United Kingdom
| | - Neil Cumberlidge
- Department of Biology, Northern Michigan University, Marquette, Michigan, United States of America
| | - Aidan M. Emery
- Department of Life Sciences, Natural History Museum, Cromwell Road, London, United Kingdom
- London Centre for Neglected Tropical Disease Research, School of Public Health, Faculty of Medicine, Imperial College London, Norfolk Place, London, United Kingdom
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43
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Xie Y, Luo YR, Chen M, Xie YM, Sun CY, Chen Q. Pleural lump after paragonimiasis treated by thoracoscopy: A case report. World J Clin Cases 2021; 9:666-671. [PMID: 33553406 PMCID: PMC7829717 DOI: 10.12998/wjcc.v9.i3.666] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/16/2020] [Accepted: 11/29/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Paragonimiasis is a parasitic disease that has multiple symptoms, with pulmonary types being common. According to our clinical practices, the pleural effusion of our patients is full of fibrous contents. Drainage, praziquantel, and triclabendazole are recommended for the treatment, but when fibrous contents are contained in pleural effusion, surgical interventions are necessary. However, no related reports have been noted. Herein, we present a case of pulmonary paragonimiasis treated by thoracoscopy.
CASE SUMMARY A 12-year-old girl presented to our outpatient clinic complaining of shortness of breath after exercise for several days. Enzyme-linked immunosorbent assay revealed positivity for antibodies against Paragonimus westermani, serological test showed eosinophilia, and moderate left pleural effusion and calcification were detected on computed tomography (CT). She was diagnosed with paragonimiasis, and praziquantel was prescribed. However, radiography showed an egg-sized nodule in the left pleural cavity during follow-up. She was then admitted to our hospital again. The serological results were normal except slight eosinophilia. CT scan displayed a cystic-like node in the lower left pleural cavity. The patient underwent a thoracoscopic mass resection. A mass with a size of 6 cm × 4 cm × 3 cm adhered to the pleura was resected. The pathological examination showed that the mass was composed of non-structured necrotic tissue, indicating a granuloma. The patient remainded asymptomatic and follow-up X-ray showed complete removal of the mass.
CONCLUSION This case highlights that thoracoscopic intervention is necessary when fibrous contents are present on CT scan or chest roentgenogram to avoid later fibrous lump formation in patients with pulmonary paragonimiasis.
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Affiliation(s)
- Yue Xie
- Department of Burns and Plastic Surgery, Children’s Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Ya-Rui Luo
- Outpatient Department, Chongqing University Three Gorges Hospital, Chongqing 404000, China
| | - Meng Chen
- Department of Pediatric Surgery, Chongqing University Three Gorges Hospital, Chongqing 400010, China
| | - Yi-Min Xie
- Department of Pediatric Surgery, Chongqing University Three Gorges Hospital, Chongqing 400010, China
| | - Chen-Yu Sun
- Department of Internal Medicine, AMITA Health Saint Joseph Hospital Chicago, Chicago, IL 60657, United States
| | - Qiang Chen
- Department of Pediatric Surgery, Chongqing University Three Gorges Hospital, Chongqing 400010, China
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A retrospective clinical analysis of pediatric paragonimiasis in a Chinese children's hospital from 2011 to 2019. Sci Rep 2021; 11:2005. [PMID: 33479468 PMCID: PMC7820331 DOI: 10.1038/s41598-021-81694-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 01/07/2021] [Indexed: 01/21/2023] Open
Abstract
Diagnosis of pediatric paragonimiasis is difficult because of its non-specific clinical manifestations. We retrospectively reviewed the records of pediatric paragonimiasis in Children's Hospital of Fudan University from January 2011 to May 2019. The confirmed diagnosis of paragonimiasis was based on positive anti-parasite serological tests from the local Center for Disease Control (CDC). A total of 11 patients (mean age: 7.7 ± 3.1, male-female ratio: 7:4) diagnosed as paragonimiasis were included. 81.8% were from endemic areas such as Sichuan and Yunnan, and 36% had a clear history of raw crab or crayfish consumption. The characteristic clinical features of pediatric paragonimiasis were eosinophilia (100%), pleural effusion (81.8%), hepatomegaly (54.5%), ascites (54.5%), and subcutaneous nodules (45.5%). Misdiagnosed with other diseases including tuberculosis (18.2%), pneumonia (9.1%), intracranial space-occupying lesions (9.1%) and brain abcess (9.1%) led to rehospitalization and prolonged hospitalization. For treatment, a 3-day course of 150 mg/kg praziquantel (PZQ) didn't show ideal treatment effectivity and 63.6% needed more than one course of PZQ, while triclabendazole in a total dose of 10 mg/kg had a better efficacy to stubborn manifestations. This study indicated that pediatric paragonimiasis was often misdiagnosed, and the treatment with a 3-day course of 150 mg/kg PZQ had a high rate of failure.
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45
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Banzai A, Sugiyama H, Hasegawa M, Morishima Y, Kawakami Y. Paragonimus westermani metacercariae in two freshwater crab species in Kagoshima Prefecture, Japan, as a possible source of infection in wild boars and sika deer. J Vet Med Sci 2021; 83:412-418. [PMID: 33473059 PMCID: PMC8025406 DOI: 10.1292/jvms.20-0576] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Paragonimiasis is a particular foodborne parasitic disease that is endemic to southern Kyushu, including Kagoshima Prefecture, Japan. We previously detected Paragonimus westermani triploid larvae in meat samples obtained from wild boars and sika deer hunted in Akune City, Kagoshima Prefecture. These mammals act as paratenic hosts and their meat is a source of human paragonimiasis. Paratenic host mammals and humans become infected with the lung fluke, P. westermani, following consumption of second intermediate hosts, freshwater crab species, namely, Geothelphusa dehaani or Sawagani in Japanese, and Eriocheir japonica or Mokuzugani in Japanese. Therefore, this study aimed to investigate the current infection status of P. westermani in freshwater crabs in Akune City. We collected freshwater crabs from 15 locations and found that the prevalence of P. westermani metacercariae was 1.6% for Sawagani (15 of 941 examined) and 22.1% for Mokuzugani (21 of 95 examined). Based on the morphological characterization of metacercariae and molecular analyses of the internal transcribed spacer 2 region and mitochondrial 16S rRNA gene region using PCR-restriction fragment length polymorphism and sequencing, all metacercariae were identified as the triploid form of P. westermani. These results indicate that Sawagani and Mokuzugani serve as second intermediate hosts to maintain the life cycle of triploid P. westermani. Further, infection in crabs potentially leads to subsequent P. westermani infections in wild mammals, including wild boars and sika deer, both of which are considered important types of game meat in Japan.
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Affiliation(s)
- Azusa Banzai
- Laboratory of Environmental Biology, School of Life and Environmental Science, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara-shi, Kanagawa 252-5201, Japan.,Department of Parasitology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan
| | - Hiromu Sugiyama
- Department of Parasitology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan
| | - Mitsuko Hasegawa
- Department of Parasitology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan.,Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki-shi, Nagasaki 852-8523, Japan
| | - Yasuyuki Morishima
- Department of Parasitology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan
| | - Yasushi Kawakami
- Laboratory of Environmental Biology, School of Life and Environmental Science, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara-shi, Kanagawa 252-5201, Japan
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46
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Nakagawa Y, Ikematsu Y, Nakanishi T, Ogawa Y, Taen R, Nakashima Y, Okabe H, Yoshida A, Maruyama H. An outbreak of Paragonimus westermani infection among Cambodian technical intern trainees in Japan, exhibiting various extrapulmonary lesions. Parasitol Int 2020; 81:102279. [PMID: 33388385 DOI: 10.1016/j.parint.2020.102279] [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: 12/15/2020] [Revised: 12/27/2020] [Accepted: 12/28/2020] [Indexed: 11/29/2022]
Abstract
We encountered an outbreak of paragonimiasis among Cambodian technical intern trainees (TITs) at a food-processing factory in Fukuoka, Japan. The patients were 20-28 years old, seven females and two males, who had been in Japan for one to four years. All of them had consumed raw or undercooked Japanese mitten crab they purchased at a local grocery store near their training place. CT images showed multiple lesions not only in the lungs but in the extrapulmonary organs as well, such as subcutaneous tissues, abdominal muscles, and mesentery, in most of the patients. Their medical records indicated that all of them acquired infection in Japan, not in Cambodia. Diagnosis was made serologically and the patients were treated with praziquantel successfully. Foreign workers and TITs are increasing in Japan so rapidly, that food borne-infections, including paragonimiasis, should be considered in people from developing countries who have exotic dietary habits.
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Affiliation(s)
| | - Yuki Ikematsu
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takayuki Nakanishi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | | | | | | | - Ayako Yoshida
- Center for Animal Disease Control, University of Miyazaki, Miyazaki, Japan; Laboratory of Veterinary Parasitic Diseases, Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan
| | - Haruhiko Maruyama
- Center for Animal Disease Control, University of Miyazaki, Miyazaki, Japan; Division of Parasitology, Department of Infectious Diseases, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
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Shrivastav S, Jha A. Paragonimiasis: A missed diagnosis from Nepal. Respir Med Case Rep 2020; 31:101298. [PMID: 33304807 PMCID: PMC7708870 DOI: 10.1016/j.rmcr.2020.101298] [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: 08/10/2020] [Revised: 10/20/2020] [Accepted: 11/16/2020] [Indexed: 11/18/2022] Open
Abstract
Paragonimiasis, or Oriental lung fluke is a parasitic infestation seen in Asia, Africa and South America which is spread by the consumption of crabs and crayfish. To date four cases have been reported from Nepal. Here, we report a case of paragonimiasis in a young male from Kathmandu valley who presented with symptoms of fever, on and off for 1 month, shortness of breath and cough. He was found to have pleural effusion. Sputum examination did not reveal acid fast bacilli, However, based on clinical features, he was started on antitubercular treatment. There was initial improvement, but later, he continued to have cough and hemoptysis over the next 2 years and on subsequent High-Resolution Computerized Tomography (HRCT) he was found to have a cavitary lung lesion in the superior segment of lower lobe of left lung. A possibility of aspergillosis was considered for which he underwent a lobectomy. The gross examination of the lung showed a small cavity measuring 5 mm which revealed on histology a parasitic structure with serous glands within it. In addition, there were many foreign body granulomas with ova within them. A diagnosis of paragonimiasis was made and the patient was started on Praziquantal. He recovered well and is currently asymptomatic. We can learn from this case that the signs and symptoms of paragonimiasis mimic that of tuberculosis and the mistaken diagnosis can lead to unnecessary treatment, prolonged morbidity and loss of time and resources.
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Affiliation(s)
- Shreya Shrivastav
- Department of Pathology, Tribhuvan University Teaching Hospital, Institute of Medicine, Maharajgunj, PO Box 1524, 44600, Nepal
- Corresponding author.
| | - Anamika Jha
- Department of Radiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Nepal
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48
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Kunitomo K, Yumoto S, Tsuji T. A Case of Paragonimiasis in a Patient with Wet Cough. Am J Trop Med Hyg 2020; 103:939-940. [PMID: 32896236 PMCID: PMC7470576 DOI: 10.4269/ajtmh.20-0395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Kotaro Kunitomo
- Department of Internal Medicine, Kumamoto Medical Center, Kumamoto, Japan
| | - Shinya Yumoto
- Department of Internal Medicine, Aso Medical Center, Kumamoto, Japan
| | - Takahiro Tsuji
- Department of Internal Medicine, Kumamoto Medical Center, Kumamoto, Japan
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Avendaño C, Patarroyo MA. Loop-Mediated Isothermal Amplification as Point-of-Care Diagnosis for Neglected Parasitic Infections. Int J Mol Sci 2020; 21:ijms21217981. [PMID: 33126446 PMCID: PMC7662217 DOI: 10.3390/ijms21217981] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 12/13/2022] Open
Abstract
The World Health Organisation (WHO) has placed twenty diseases into a group known as neglected tropical diseases (NTDs), twelve of them being parasitic diseases: Chagas’ disease, cysticercosis/taeniasis, echinococcosis, food-borne trematodiasis, human African trypanosomiasis (sleeping sickness), leishmaniasis, lymphatic filariasis, onchocerciasis (river blindness), schistosomiasis, soil-transmitted helminthiasis (ascariasis, hookworm, trichuriasis), guinea-worm and scabies. Such diseases affect millions of people in developing countries where one of the main problems concerning the control of these diseases is diagnosis-based due to the most affected areas usually being far from laboratories having suitable infrastructure and/or being equipped with sophisticated equipment. Advances have been made during the last two decades regarding standardising and introducing techniques enabling diagnoses to be made in remote places, i.e., the loop-mediated isothermal amplification (LAMP) technique. This technique’s advantages include being able to perform it using simple equipment, diagnosis made directly in the field, low cost of each test and the technique’s high specificity. Using this technique could thus contribute toward neglected parasite infection (NPI) control and eradication programmes. This review describes the advances made to date regarding LAMP tests, as it has been found that even though several studies have been conducted concerning most NPI, information is scarce for others.
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Affiliation(s)
- Catalina Avendaño
- Animal Science Faculty, Universidad de Ciencias Aplicadas y Ambientales (U.D.C.A.), Bogotá 111166, Colombia;
| | - Manuel Alfonso Patarroyo
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá 111321, Colombia
- Basic Sciences Department, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá 112111, Colombia
- Correspondence: ; Tel.: +57-1-3244672
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Spectrum of pleuropulmonary paragonimiasis: An analysis of 685 cases diagnosed over 22 years. J Infect 2020; 82:150-158. [PMID: 33017628 DOI: 10.1016/j.jinf.2020.09.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 09/28/2020] [Accepted: 09/30/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Paragonimiasis is a global foodborne zoonosis. Overlapping clinical and imaging features with other lung pathologies hamper correct diagnosis and require differential diagnosis. METHODS During 1982-2003, 49,012 samples were referred for immunodiagnosis of helminthiases. We detected paragonimiasis cases by enzyme-linked immunosorbent assay (ELISA). We assessed clinical, radiographical and laboratory characteristics, and diagnostic dilemmas associated with delayed diagnosis. RESULTS We analyzed 685 pleuropulmonary paragonimiasis cases. ELISA-positive was 665. Eggs were detected in 50. Symptom duration correlated well with the appearance of chest radiographs; 359 pleural, 33 pleuroparenchymal, and 264 parenchymal lesions (P < 0.001). Twenty-nine had normal chest images. Eosinophilia, seen in 304, was common in pleural and pleuroparenchymal patients (P < 0.05). Chest pain and dyspnea were characteristic for pleurisy patients. Sputum (odds ratios [OR]: 6.79; 95% CI: 4.41-10.47), blood-tinged sputum (OR: 5.62; 95% CI: 3.75-8.42), and foul-odor (OR: 2.70; 95% CI: 1.42-5.16) were significant in parenchymal patients. Delayed diagnosis (119) for ≥ 25 weeks was attributed mainly to misdiagnosis as tuberculosis, malignancy, or chronic obstructive pulmonary disease (COPD) (OR: 111.75; 95% CI: 43.25-288.74). CONCLUSIONS Variable symptoms and radiographs of pleuropulmonary paragonimiasis depended on the stage of infection. Suspicion of tuberculosis, malignancy, or COPD was major cause of delayed diagnosis.
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