One delayed diagnosis of paragonimiasis case and literature review

Kong, Luxia; Hua, Lijuan; Liu, Qian; Bao, Chen; Hu, Jiannan; Xu, Shuyun

doi:10.1002/rcr2.750

Cited by 3 publications

(5 citation statements)

References 36 publications

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“…The diversity and lack of specificity of clinical symptoms, signs, and laboratory tests can easily lead to misdiagnosis. As shown in previous studies, paragonimiasis can be easily misdiagnosed as tuberculosis or cancer ( 10 , 11 ); 6 cases had been misdiagnosed as tuberculosis, tumor, and viral encephalitis in our study. The radiographic findings, which presented in our results, are also found in other diseases, such as pneumonia, lung neoplasms, tuberculosis, central nervous system neoplasms, vascular diseases, and inflammatory disorders ( 10 , 12 , 13 ).…”

Section: Discussionsupporting

confidence: 74%

Pediatric paragonimiasis: a retrospective analysis of cases from a county in south-west China

Jiang¹,

Li²,

Pan³

et al. 2023

Front. Pediatr.

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IntroductionThe clinical manifestations of paragonimiasis are diverse and non-specific, and can easily lead to misdiagnosis. We aimed to analyze the clinical manifestations, laboratory features, treatment, and clinical outcome of children with paragonimiasis in order to improve recognition of this disease and avoid misdiagnosis.MethodsChildren diagnosed with paragonimiasis from August 2016 to July 2022 were included in the study. Information on population informatics, medical history, and laboratory features was extracted from case data. The clinical features of paragonimiasis were retrospectively analyzed.ResultsA total of 45 children were included in this study. All children had, at least, one risk factor. The clinical features mainly included fever, cough, pleural effusion, peritoneal effusion, and subcutaneous nodules. The main imaging findings were alveolar exudation, peritoneal effusion, pleural thickening, and local nodules. The “tunnel sign” finding on computed tomography (CT)/magnetic resonance imaging (MRI) was helpful in establishing the diagnosis of paragonimiasis. After praziquantel treatment, most of the children improved, and one child with cerebral paragonimiasis experienced sequelae.ConclusionMost children with paragonimiasis have a good prognosis, but few children can experience sequelae. Avoidance of untreated water and raw food is a simple, feasible, and effective preventive measure.

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Section: Discussionsupporting

confidence: 74%

Pediatric paragonimiasis: a retrospective analysis of cases from a county in south-west China

Jiang¹,

Li²,

Pan³

et al. 2023

Front. Pediatr.

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“…Several studies have shown Paragonimus ova in 55.6 to 72% of the sputum specimens, 1 , 8 and 11%-15% for a stool sample. 9 A radiological finding of pleural effusion in patients with pleuropulmonary paragonimiasis has been reported to vary from 2.9% to 69%.…”

Section: Discussionmentioning

confidence: 99%

“…All the manifestations of the patients promptly settled down in a few days after receiving treatment as per recommendation. 1 , 3 …”

Section: Discussionmentioning

confidence: 99%

“…Most cases infected with Paragonimus westermani are consistently reported from Asia, Africa and South America because of cultural dietary customs of ingesting raw or undercooked crustacean harbouring metacercariae, the infective stage. 1 However, few cases are reported from Nepal. 2 Most of the cases are misdiagnosed due to similar clinical conditions which do not show specific symptoms.…”

Section: Introductionmentioning

confidence: 99%

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Pulmonary Paragonimiasis: A Case Series

et al. 2023

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Paragonimiasis contributes to significant foodborne zoonosis worldwide. The major mode of transmission in humans is by consumption of uncooked or undercooked crabs and crayfish harbouring Paragonimus metacercariae. It begins with symptoms like fever and lower respiratory involvement from a few months to a year, mimicking those of tuberculosis and leading to diagnostic delay. Here, we report two cases of paragonimiasis during a period of nine months. Both cases presented with symptoms of productive cough with rusty sputum, chest pain, along with eosinophilia, and pleural effusion and had a history of consumption of smoked crab from the local river. The diagnosis was established by microscopic demonstration of Paragonimus ova in the sputum. They were treated with praziquantel and recovered. Indeed, it is challenging to diagnose paragonimiasis due to the lack of its specific symptoms but should be considered in the differential diagnosis of eosinophilia and pleural effusion in such lung diseases.

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“…Although some cases are asymptomatic, the presenting symptoms typically include cough, the accumulation of sputum, and chest pain [ 1 ]. Delayed diagnosis has been reported due to the presence of atypical symptoms or an abnormal clinical course [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

A Cluster of Paragonimiasis with Delayed Diagnosis Due to Difficulty Distinguishing Symptoms from Post-COVID-19 Respiratory Symptoms: A Report of Five Cases

et al. 2023

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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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One delayed diagnosis of paragonimiasis case and literature review

Cited by 3 publications

References 36 publications

Pediatric paragonimiasis: a retrospective analysis of cases from a county in south-west China

Pediatric paragonimiasis: a retrospective analysis of cases from a county in south-west China

Pulmonary Paragonimiasis: A Case Series

A Cluster of Paragonimiasis with Delayed Diagnosis Due to Difficulty Distinguishing Symptoms from Post-COVID-19 Respiratory Symptoms: A Report of Five Cases

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