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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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Kanne JP, Rother MDM. Pneumothorax: Imaging Diagnosis and Etiology. Semin Roentgenol 2023; 58:440-453. [PMID: 37973273 DOI: 10.1053/j.ro.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/30/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Jeffrey P Kanne
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI.
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Acharya AB, Bhatta N, Mishra DR, Verma A, Shahi R. Rare Cause of Tension Pneumothorax: Hydatid Disease of Lung: A Case Report. ACTA ACUST UNITED AC 2020; 58:265-268. [PMID: 32417867 PMCID: PMC7580465 DOI: 10.31729/jnma.4693] [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: 11/24/2022]
Abstract
Lung is the second most common site of hydatid disease, after liver. Pleural involvement of hydatid disease can occur, and usually follows the rupture of a pulmonary or hepatic hydatid cyst into the pleural space. When a patient presents with tension pneumothorax, zoonotic infections, especially hydatid disease of the lung, also has to be considered especially in areas with high burden of the disease. We report a 31 years male patient presenting with tension pneumothorax due to rupture of hydatid cyst of lung.
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Affiliation(s)
- Achyut Bhakta Acharya
- Department of Pulmonary, Critical Care and Sleep Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Narendra Bhatta
- Department of Pulmonary, Critical Care and Sleep Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Deebya Raj Mishra
- Department of Pulmonary, Critical Care and Sleep Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Avatar Verma
- Department of Pulmonary, Critical Care and Sleep Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Rejina Shahi
- Department of Pulmonary, Critical Care and Sleep Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
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A Potentially Fatal Error in Diagnosis of a Pulmonary Hydatid Cyst. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2017. [DOI: 10.5812/archcid.57296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Chacko J, Raot S, Basawaraj K, Chatterjee S. Ruptured hydatid cyst masquerading as tension pneumothorax. Anaesth Intensive Care 2010; 37:840-2. [PMID: 19775053 DOI: 10.1177/0310057x0903700538] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We report a 35-year-old man who presented to us with features suggestive of a tension pneumothorax. However insertion of a chest tube did not result in any signs of improvement. Further investigation demonstrated that he had a ruptured hydatid cyst. He underwent an emergency thoractomy and excision of the cyst. Ruptured hydatid cyst should be considered as a possibility in patients who present with sudden onset respiratory distress and hypoxia in geographical areas where the disease may be prevalent.
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Affiliation(s)
- J Chacko
- Multidisciplinary Intensive Care Unit, Manipal Hospital, Bangalore, Karnataka, India
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Yekeler E, Celik O, Becerik C. A giant ruptured hydatid cyst causing tension pneumothorax and hemothorax in a patient with blunt thoracic trauma: a rare case encountered in the emergency clinic. J Emerg Med 2009; 43:111-3. [PMID: 19592190 DOI: 10.1016/j.jemermed.2009.04.066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2008] [Revised: 03/10/2009] [Accepted: 04/16/2009] [Indexed: 10/20/2022]
Affiliation(s)
- Erdal Yekeler
- Department of Thoracic Surgery, Erzurum Region Training and Research Hospital, Erzurum, Turkey
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Turgut AT, Altinok T, Topçu S, Koşar U. Local complications of hydatid disease involving thoracic cavity: imaging findings. Eur J Radiol 2008; 70:49-56. [PMID: 18291609 DOI: 10.1016/j.ejrad.2008.01.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2007] [Revised: 01/06/2008] [Accepted: 01/10/2008] [Indexed: 01/13/2023]
Abstract
Hydatid disease, a worldwide zoonosis, is caused by the larval stage of the Echinococcus tapeworm. Although it can involve almost every organ of the body, lung involvement follows in frequency the hepatic infestation in adults and is the predominating site in children. Radiologically, hydatidosis usually demonstrates typical findings, but many patients are at risk of developing various complications of hydatid disease with atypical imaging findings and these are rarely described in the literature. In this pictorial review, the imaging features of local complications of hydatid disease involving the thorax including intrapulmonary or pleural rupture, infection of the ruptured cysts, reactions of the adjacent tissues, thoracic wall invasion and iatrogenic involvement of pleura are described. Additionally, imaging characteristics of transdiaphragmatic thoracic involvement of hepatic hydatid disease are presented. To prevent the development of subsequent catastrophic results, all radiologists need to be aware of the atypical imaging appearances of complications of pulmonary hydatid disease.
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Affiliation(s)
- A T Turgut
- Department of Radiology, Ankara Training and Research Hospital, Ankara, Turkey.
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Imaging of Parasitic Diseases of the Thorax. IMAGING OF PARASITIC DISEASES 2008. [PMCID: PMC7120608 DOI: 10.1007/978-3-540-49354-9_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A broad spectrum of parasitic infections frequently affects the lungs, mediastinum, and thoracic wall, manifesting with abnormal imaging findings that often make diagnosis challenging. Although most of these infections result in nonspecific abnormalities, familiarity with their imaging features and the diagnostic pathways help the radiologist to formulate an adequate differential diagnosis and to guide diagnosticians in reaching a definitive diagnosis.
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Turgut AT, Altin L, Topçu S, Kiliçoğlu B, Aliinok T, Kaptanoğlu E, Karademir A, Koşar U. Unusual imaging characteristics of complicated hydatid disease. Eur J Radiol 2007; 63:84-93. [PMID: 17275238 DOI: 10.1016/j.ejrad.2007.01.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2006] [Revised: 12/31/2006] [Accepted: 01/02/2007] [Indexed: 12/20/2022]
Abstract
Hydatid disease, a worldwide zoonosis, is caused by the larval stage of the Echinococcus tapeworm. Although the liver and the lungs are the most frequently involved organs in the body, hydatid cysts of other organs are unusual. Radiologically, they usually demonstrate typical imaging findings, but unusual imaging characteristics of complicated cyst of hydatid disease, associated with high morbidity and mortality, are rarely described in the literature. The purpose of this study is to review the general features of hydatidosis and to discuss atypical imaging characteristics of the complicated hydatid disease in the human, with an emphasis on structure and rupture of the cystic lesion as well as ultrasonography (USG), computed tomography (CT), and magnetic resonance imaging (MRI) features of the disease. In our study, the available literature and images of the cases with complicated hydatidosis involving liver, lung, brain, spine and orbit were reviewed retrospectively. In hydatid disease, there are many potential local and systemic complications due to secondary involvement in almost any anatomic location in humans. Radiologically, in addition to the presence of atypical findings such as perifocal edema, non-homogenous contrast enhancement, multiplicity or septations and calcification, various unusual manifestations due to rupture or infection of the cyst have been observed in our cases with complicated hydatid disease. To prevent subsequent acute catastrophic results and the development of recurrences in various organs, it should be kept in mind that complicated hydatid cysts can cause unusual USG, CT, and MRI findings, in addition to typical ones, in endemic areas. Therefore, familiarity with atypical radiological appearances of complicated hydatid disease may be valuable in making a correct diagnosis and treatment.
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Affiliation(s)
- Ahmet Tuncay Turgut
- Department of Radiology, Ankara Training and Research Hospital, Ankara, Turkey.
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Kuzucu A, Soysal O, Ozgel M, Yologlu S. Complicated hydatid cysts of the lung: clinical and therapeutic issues. Ann Thorac Surg 2004; 77:1200-4. [PMID: 15063234 DOI: 10.1016/j.athoracsur.2003.09.046] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/18/2003] [Indexed: 12/13/2022]
Abstract
BACKGROUND The clinical presentation and the preoperative and postoperative complications associated with pulmonary hydatid cysts depend on whether the cyst is intact or ruptured. The aim of this study was to review the problems encountered in treating ruptured pulmonary hydatid cysts and to highlight the risks associated with chemotherapy and the delay of surgical treatment in pulmonary hydatid disease. METHODS The medical records for 67 patients of pulmonary hydatidosis were retrospectively investigated. The patients were divided into two groups based on whether the pulmonary cyst was intact (group 1, n = 34) or complicated (group 2, n = 33). A complicated cyst was defined as one that had ruptured into a bronchus or into the pleural cavity. All patients were treated surgically. Data related to symptoms, preoperative complications, surgical procedures performed, postoperative morbidity, hospitalization time, and cyst recurrence were collected from each individual's records, and the group findings were compared. RESULTS In most cases of intact pulmonary hydatid cysts, the lesions were either incidental findings or the patient had presented with cough, dyspnea and chest pain. In addition to these symptoms, the patients with complicated cyst had presented with problems such as expectoration of cystic contents, repetitive hemoptysis, productive sputum, and fever. The differences between the groups with respect to the rates of preoperative complications and postoperative morbidity, frequency of decortication, and hospital stay were statistically significant (p < 0.05). CONCLUSIONS Surgery is the primary mode of treatment for patients with pulmonary hydatid disease. Complicated cases have higher rates of preoperative and postoperative complications and require longer hospitalization time and more extensive surgical procedures than uncomplicated cases. This underlines the need for immediate surgery in any patient who is diagnosed with pulmonary hydatidosis.
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Affiliation(s)
- Akin Kuzucu
- Department of Thoracic Surgery, Inönü University, Faculty of Medicine, Turgut Ozal Medical Center, Malatya, Turkey.
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Raether W, Hänel H. Epidemiology, clinical manifestations and diagnosis of zoonotic cestode infections: an update. Parasitol Res 2003; 91:412-38. [PMID: 13680371 DOI: 10.1007/s00436-003-0903-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2003] [Accepted: 05/21/2003] [Indexed: 02/06/2023]
Abstract
This paper reviews the literature on zoonotic cestode infections with specific reference to the years 1999-2003. The sources and prevalence of various zoonotic tapeworm infections caused by adult and larval stages of the genera Taenia, Echinococcus, Diphyllobothrium, Hymenolepis and Dipylidium continue to be an important cause of morbidity and mortality, not only in most underdeveloped countries but also in industrialized countries, particularly in rural areas or among immigrant groups from endemic areas. The review gives a detailed report on recent molecular epidemiological studies on the taxonomy and phylogenetic variations in Echinococcus granulosus, immunological tests and imaging techniques used in epidemiological surveys and clinical investigations of important adult and larval tapeworm infections of animals and humans. Larval stages or metacestodes of Taenia solium, Echinococcus spp. and pseudophyllidean tapeworms (Spirometra syn. Diphyllobothrium spp.) may reside in various tissues of their intermediate hosts, including humans. In particular, Cysticercus cellulosae (T. solium) and the larvae of E. granulosus, and E. multilocularis, which are predominantly located in the liver, lungs and central nervous system forming various types of cysts, lead to a complex of systemic diseases such as cysticercosis, cystic echinococcosis and alveolar echinococcosis, respectively. Relatively rare clinical manifestations are seen in the muscles, subcutaneous tissue, spleen, kidneys, bones and body cavities.
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Affiliation(s)
- W Raether
- Fa Aventis, ADMEP /Q0/10, 65926 Frankfurt am Main, Germany
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