Paragonimiasis as an Important Alternative Misdiagnosed Disease for Suspected Acid-fast Bacilli Sputum Smear–Negative Tuberculosis

Hubert, Bernard; Slesak, Günther; Buisson, Y.; Odermatt, Peter

doi:10.4269/ajtmh.13-0710

Cited by 12 publications

(6 citation statements)

References 8 publications

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“…[ 13 , 21 ] Respiratory symptoms of can be easily confused with those of TB. [ 12 , 24 ] Additionally, Barennes et al [ 25 ] reported that 3 (2.5%) of 118 patients with negative acid-fast bacilli smear who were suspected to have pulmonary TB were diagnosed with paragonimiasis. However, no report about paragonimiasis patients coinfected with TB is available.…”

Section: Discussionmentioning

confidence: 99%

Paragonimiasis in Children in Southwest China

et al. 2017

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Background:Paragonimiasis infection has no specific symptoms or typical radiologic findings, leading to the possibility of misdiagnosis. Thus, the objective of this study was to analyze clinical and radiological features, and treatment outcome of paragonimiasis in children in Southwest China to improve the awareness of this disease.Methods:We retrospectively reviewed the records of children diagnosed with paragonimiasis in West China Second University Hospital between 2005 and 2016. The confirmed diagnosis of paragonimiasis was based on epidemiology history and seropositivity for paragonimiasis and/or detection of paragonimus eggs. Clinical, laboratory, and imaging findings of patients were examined in order to summarize risk factors, clinical characteristics, and treatment outcomes of these patients.Results:A total of 123 patients were included; of them 112 (91.1%) lived in villages and 72 (58.5%) had a history of consuming freshwater crabs. Patients with paragonimiasis most frequently showed respiratory symptoms, including cough (26.0%, 32/123) and tachypnea (16.3%, 20/123), and gastrointestinal symptoms, including abdominal pain (26.8%, 33/123), abdominal distention (22.8%, 28/123), and vomiting (13.0%, 16/123). Laboratory examination showed elevated white blood cell (WBC) counts in the peripheral blood in 89 (72.4%) patients and eosinophilia in 102 (82.9%) patients. Tuberculosis (TB) coinfection was found in 4 (3.3%) patients. Main imaging findings included: effusions (90.4%), lymphadenopathy (40.4%), pulmonary ground-glass opacities (36.2%), cystic lesions (18.1%), and pleural thickening (17.0%). Twenty-nine patients (23.6%) received more than 1 course of praziquantel (PZQ). Additionally, 4 (19.0%) of 21 patients who were discharged from the hospital without complete treatment required rehospitalization for residual serous effusions. Moreover, patients from pericardial effusion group showed longer hospital stays and less elevated WBC counts than those from nonpericardial effusion group.Conclusion:Paragonimiasis should be considered in patients from endemic areas, especially in those with gastrointestinal and/or respiratory symptoms, elevated WBC count, eosinophilia, and serous effusions. Additionally, longer hospital stay may be necessary in cases of paragonimiasis associated with pericardial effusions.

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Section: Discussionmentioning

confidence: 99%

Paragonimiasis in Children in Southwest China

et al. 2017

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“…However, it is an important differential diagnosis for TB in the appropriate context, with similar clinical and radiological features, and overlapping epidemiological risk factors, including travel to or emigration from an endemic country. Like TB, paragonimiasis may only become evident many years after exposure, manifesting with productive cough, haemoptysis, cavitating lesions or pleural effusion on radiography . While TB most commonly affects the upper lobe(s) in immunocompetent hosts, paragonimiasis lesions are typically peripheral and affect the middle and lower lobes .…”

Section: Discussionmentioning

confidence: 99%

Mycobacterial mimicry in a man from Myanmar

Griffin

Huang

Lachapelle

et al. 2019

Medical Journal of Australia

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“…Paragonimiasis is a neglected yet emerging global health problem. It is especially important as differential diagnosis of TB [ 6 , 16 ] and its potential large cost implications of mis-diagnosis for TB control programs. Although previous reports suggest that the disease is present in the Senegambian region we did not detect any cases of Paragonimus DNA in samples from symptomatic but TB-smear negative patients.…”

Section: Discussionmentioning

confidence: 99%

Examining human paragonimiasis as a differential diagnosis to tuberculosis in The Gambia

et al. 2018

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ObjectiveParagonimiasis is a foodborne trematode infection of the lungs caused by Paragonimus spp., presenting clinically with similar symptoms to active tuberculosis (TB). Worldwide, an estimated 20.7 million people are infected with paragonimiasis, but relatively little epidemiological data exists for Africa. Given a recently reported case, we sought to establish whether paragonimiasis should be considered as an important differential diagnosis for human TB in The Gambia, West Africa.ResultsWe developed a novel PCR-based diagnostic test for Paragonimus species known to be found in West Africa, which we used to examine archived TB negative sputum samples from a cross-sectional study of volunteers with tuberculosis-like symptoms from communities in the Western coastal region of The Gambia. Based on a “zero patient” design for detection of rare diseases, 300 anonymised AFB smear negative sputum samples, randomly selected from 25 villages, were screened for active paragonimiasis by molecular detection of Paragonimus spp. DNA. No parasite DNA was found in any of the sputa of our patient group. Despite the recent case report, we found no evidence of active paragonimiasis infection masking as TB in the Western region of The Gambia.Electronic supplementary materialThe online version of this article (10.1186/s13104-018-3134-y) contains supplementary material, which is available to authorized users.

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Paragonimiasis as an Important Alternative Misdiagnosed Disease for Suspected Acid-fast Bacilli Sputum Smear–Negative Tuberculosis

Cited by 12 publications

References 8 publications

Paragonimiasis in Children in Southwest China

Paragonimiasis in Children in Southwest China

Mycobacterial mimicry in a man from Myanmar

Examining human paragonimiasis as a differential diagnosis to tuberculosis in The Gambia

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