Unresolving Pneumonia with Pleural effusion: Pulmonary Paragonimiasis
Paragonimiasis is a zoonosis caused by many species of Paragonimus commonly P. westermani. Human get infected by eating raw, salted, pickled, smoked, partially cooked crustaceans (crayfish or crabs). Clinical manifestations ranges from non-specific symptoms like pain abdomen, diarrhea, urticarial rashes, fever to pleuropulmonary symptoms like cough, hemoptysis, chest pain and dyspnea. 48 yrs, female presented at TUTH emergency with fever on and off for 9 months, cough and shortness of breath for 3 months, lethargy, malaise and urticaria with history of raw crab intake one month prior to the onset of symptoms. Blood and pleural fluid analysis revealed raised total counts with eosinophilia and x-ray showed bilateral infiltration of lower lobes with pleural effusion. Diagnosis was confirmed by microscopic examination of sputum for Paragonimus. She responded well to Praziquantel. Pulmonary paragonimiasis must be considered in the differential diagnosis of unresolving pneumonia and unexplained hypereosinophilia. [PubMed]
2. Haswell-Elkins MR, Elkins DB. Lung and liver flukes. In: Leslie C, Albert B, Max S, ed Topley and Wilson’s Microbiology and Microbial Infections; 9th edn, Vol. V. New York: Oxford University Press; 1998: 507-20. [Full text]
3. Procop GW, Marty AM, Scheck DN, Mease DR etal. North American Paragonimiasis: a case report. Acta cytol. 2000 Jan-Feb;44(1),75-80. [Pubmed]
4. Yokogawa M (1965). Paragonimus and paragonimiasis. Adv parasitol. 1969;7:375-87. [Pubmed]
5. Wiwanitkit V. A summary of respiratory symptoms in Thai cases with pulmonary paragonimiasis. Internet J infect Dis. 2004;4:1. [Full text]
6. Singh TS, Sugimaya H, Umehata A, Hiese S, Khalo K. Paragonimus heterotremus infection in Nagaland: A new focus of paragonimiasis in India. Indian J Med. Microbial. 2009 Apr-Jun;27(2):123-7. [Full text]
7. CJ Chinwe, CO Cejatan. Paragonimiasis: an unusual case of corpulmonale; a case report. Respi Med. CME 2011,vol.4(3):136-7. [doi]
8. Defrain M, Hooker R. North American Paragonimiasis- case of severe clinical infection. chest April 2002,121(4):1368-72. [Pubmed]
9. Singh TS, Sugiama H, Rangsiruji A. Paragonimus and paragonimiasis in India. Indian J med Res 2012 Aug;136(2):192-204. [PMC]
10. Liu Q, Wei F, Liu W, Yang S, Zhang X. Pargonimiasis:an important food- borne zoonosis in china. Trends parasitol. 2008 Jul;24(7):318-23. [Pubmed]
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