Paragonimiasis

Introduction

Paragonimiasis is primarily a lung disease caused by the fluke paragonimus 

-it is prevalent in Southeast Asia, Africa, and South and Central America. 

-Human infection follows consumption of undercooked or raw crustaceans such as shellfish, crayfish and crabs 

-After consumption, larvae enter the gut and later burrow through diaphragm into lung parenchyma 

Symptoms & Signs 

Lung disease: Fever, cough, chest pain, hemoptysis with rusty, blood-tinged sputum containing Charcot-Leyden crystals, dyspnea, bronchitis, bronchiectasis, lung abscess,  urticaria, and eosinophilia

-Individuals may be mistaken for having tuberculosis 

Extrapulmonary involvement: Blindness, epididymitis, testicular inflammation, and seizures 

Diagnosis 

Diagnosis is made by finding the characteristic eggs in sputum, urine, or stool, or by identifying worms in biopsied tissues 

-Serologic tests help in making diagnosis and monitoring treatment response

Chest X-ray: small segmental infiltrates, round nodules, cystic rings with a crescent corona, fibrosis, abscesses and calcifications

Skull imaging in CNS disease: clusters of calcified cysts, ring-enhancing lesions

Treatment

The treatment of choice is praziquantel or triclabendazole.

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