American Paragonimiasis Treated with Praziquantel

Pachucki, Constance T.; Levandowski, Roland A.; Brown, Valerie A.; Sonnenkalb, Brigitta H.; Vruno, Michael J.

doi:10.1056/nejm198408303110906

Cited by 48 publications

(41 citation statements)

References 3 publications

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“…The authors noted that the diagnosis of paragonimiasis was delayed for up to 6 months in 2 patients due to the unfamiliarity of U.S. clinicians with the presenting manifestations of paragonimiasis, and they urged clinicians to consider lung fluke infections in Southeast Asian refugee children with chronic pulmonary symptoms and hemoptysis and to examine the stool and sputum for P. westermani eggs (16). Although bithionol is available from the Drug Service of the U.S. Centers for Disease Control and Prevention (CDC), bithionol therapy for paragonimiasis has now been replaced by oral praziquantel at 75 mg/kg/day in 3 divided doses over 2 to 3 days (17).…”

Section: Nonnative Paragonimiasis In the United Statesmentioning

confidence: 99%

Paragonimiasis Acquired in the United States: Native and Nonnative Species

Diaz

2013

Clin Microbiol Rev

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SUMMARY Paragonimiasis is a parasitic lung infection caused by lung flukes of the genus Paragonimus , with most cases reported from Asia and caused by P. westermani following consumption of raw or undercooked crustaceans. With the exception of imported P. westermani cases in immigrants, in travelers returning from areas of disease endemicity, and in clusters of acquired cases following consumption of imported Asian crabs, human paragonimiasis caused by native lung flukes is rarely described in the United States, which has only one indigenous species of lung fluke, Paragonimus kellicotti . Clinicians should inquire about the consumption of raw or undercooked freshwater crabs by immigrants, expatriates, and returning travelers, and the consumption of raw or undercooked crayfish in U.S. freshwater river systems where P. kellicotti is endemic when evaluating patients presenting with unexplained fever, cough, rales, hemoptysis, pleural effusions, and peripheral eosinophilia. Diagnostic evaluation by specific parasitological, radiological, serological, and molecular methods will be required in order to differentiate paragonimiasis from tuberculosis, which is not uncommon in recent Asian immigrants. All cases of imported and locally acquired paragonimiasis will require treatment with oral praziquantel to avoid any potential pulmonary and cerebral complications of paragonimiasis, some of which may require surgical interventions.

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Section: Nonnative Paragonimiasis In the United Statesmentioning

confidence: 99%

Paragonimiasis Acquired in the United States: Native and Nonnative Species

Diaz

2013

Clin Microbiol Rev

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“…One patient had a 3-day course of watery diarrhea following the ingestion of the infected crayfish (49). Another patient developed a fever to 40°C and malaise within 2 weeks of the ingestion event; the interpretation of the early clinical findings for this patient, however, was complicated by the high likelihood of a concomitant acute EpsteinBarr virus infection (138).…”

Section: Acute Paragonimiasis (Early-stage Disease)mentioning

confidence: 86%

“…Uchiyama et al have described pleural manifestations as predominating early in the disease process, whereas pulmonary parenchymal lesions predominate later in the course of disease, which is consistent with the life cycle of this parasite (182). Manifestations of pleurabased disease, which occur relatively early in the course of an infection, have also been documented for two of the patients with North American paragonimiasis (30,49,138). One of these patients developed dyspnea, left pleuritic chest pain, and a left-sided pneumothorax approximately a month after the initiation of infection.…”

Section: Acute Paragonimiasis (Early-stage Disease)mentioning

confidence: 86%

“…All of these patients had pleural effusions, whereas two had pneumothoraces (30,49,100,138). One of these patients, who had abundant eggs present in the pleural peel and recurrent pneumothoraces, did not have a history of hemoptysis.…”

Section: Chronic Pleuropulmonary Paragonimiasis (Late-stage Disease)mentioning

confidence: 97%

“…This Paragonimus species is unknown to many health care providers because of the paucity of infections in humans. Only five patients with North American paragonimiasis have been reported in the medical literature since the mid-1980s (30,49,111,138,141). Paragonimiasis in the United States and Canada may also be due to imported disease.…”

Section: Introductionmentioning

confidence: 99%

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North American Paragonimiasis (Caused by Paragonimus kellicotti ) in the Context of Global Paragonimiasis

2009

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SUMMARY Paragonimus species are highly evolved parasites with a complex life cycle that involves at least three different hosts, i.e., snails, crustaceans, and mammals. The adult forms of Paragonimus species reside and mate in the lungs of a variety of permissive mammalian hosts, including humans. Although human paragonimiasis is uncommonly encountered in North America, both autochthonous and imported disease may be encountered. Paragonimus kellicotti, the species endemic to North America, is a well-known pathogen in wild and domestic animals. Five patients with North American paragonimiasis have been reported in the recent medical literature. The biologic, clinical, radiologic, and laboratory features of paragonimiasis are reviewed, with emphasis on North American paragonimiasis whenever possible.

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Paragonimiasis

2013

Emerging Epidemics

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American Paragonimiasis Treated with Praziquantel

Cited by 48 publications

References 3 publications

Paragonimiasis Acquired in the United States: Native and Nonnative Species

Paragonimiasis Acquired in the United States: Native and Nonnative Species

North American Paragonimiasis (Caused by Paragonimus kellicotti ) in the Context of Global Paragonimiasis

Paragonimiasis

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