Paragonimiasis diagnosed by CT-guided transthoracic lung biopsy: Literature review and case report

Cong, Cung-Van; Anh, Tran-Thi Tuan; Duc, Nguyen Minh

doi:10.1016/j.radcr.2022.02.046

Cited by 4 publications

(5 citation statements)

References 10 publications

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“…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 ). In addition to paragonimiasis, a significant increase in the percentage of eosinophils is also seen in many diseases, such as allergic diseases, other parasitic infections, eosinophilic gastritis, hypereosinophilic syndrome, and mycotic infection ( 10 ).…”

Section: Discussionsupporting

confidence: 82%

“…If necessary, a tissue biopsy can also be used for establishing the diagnosis ( 14 ). CT or MRI may reveal migratory symptoms or the tunnel sign, which are related to the migration of Paragonimus larvae, and these findings may be useful to establish the diagnosis ( 13 , 14 ).…”

Section: Discussionmentioning

confidence: 99%

“…Brain MRI showed the lesion and its surrounding edema (A, B), and tunnel-like transitional signs (C). tuberculosis, central nervous system neoplasms, vascular diseases, and inflammatory disorders (10,12,13). In addition to paragonimiasis, a significant increase in the percentage of eosinophils is also seen in many diseases, such as allergic diseases, other parasitic infections, eosinophilic gastritis, hypereosinophilic syndrome, and mycotic infection (10).…”

Section: Discussionmentioning

confidence: 99%

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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: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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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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“…Contrarily, Paragonimiasis has been divided into three categories by Procop et al (2009): Ectopic Paragonimiasis, Chronic Pleuropulmonary Paragonimiasis, and Acute Paragonimiasis 4 .In India's north-eastern states, paragonimiasis and tuberculosis are widespread and paragonimiasis is infrequently included in the distinctive diagnosis of TB. Due to its similarity to the clinical presentation of TB, diagnosis is typically delayed 14 .Paragonimiasis can be misdiagnosed and neglected and often treated with anti-TB medication when it mimics smear-negative pulmonary TB, especially in high-prevalence countries 30 .…”

Section: Clinical Manifestations In Humansmentioning

confidence: 99%

“…However, in a carefully dissected cystic lesion or nodular we may find immature adult helminths. As an alternative, a histological analysis will also reveal eosinophils, inflammatory cells, fibro collagenous tissue, sections of the helminths, and deformed eggs 4 .Following the failure of histological and cytologic procedures, a lung biopsy can be performed to ensure a diagnosis of PRG 14 .…”

Section: Biopsymentioning

confidence: 99%

A Review on Paragonimiasis and its Differential Diagnosis Technique

Resuh,

Kotso,

Kera

et al. 2024

Biosci., Biotech. Res. Asia

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This review highlights the existence of Paragonimus (PRG) and how they are mistaken for Tuberculosis (TB) during diagnosis. PRG is a parasitic lung fluke (flatworm) that infect the lungs, human serves as the first hosts, crabs, crayfish, and snails as the second intermediate hosts. The north-eastern states of India are endemic to PRG and infection is acquired by consuming uncooked or partially cooked crustaceans. Due to their similar clinical presentation to TB, PRGs are usually misdiagnosed, leading to delayed treatment. Ziehl-Neelsen (ZN) stain, conventional wet film for staining the sputum, pleural fluid, and stool, and lung biopsy are different laboratory tests to determine PRG infection. In addition, efficient technique that can aid diagnosis are immunological assays, like Enzyme-linked immunosorbent assay (ELISA), dot-ELISA, complement fixation test (CFT), intradermal test (ID), Western blot, immunodiffusion and indirect haemagglutination test (IHA). In India, PRG infection is most likely to persist until medical professionals and governing bodies raise awareness to implement adequate management measures.

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