Paragonimus and paragonimiasis in Korea

Abstract

The lung fluke, Paragonimus, and lung fluke disease, were reviewed, especially on the works performed in Korea. Among 43 species of Paragonimus recorded in the world literature, P. westermani, P. pulmonalis, and P. iloktsuenensis are known to distribute in Korea. Biological studies on P. westermani have revealed that its snail intermediate host is Semisulcospira spp. and major second intermediate hosts are crabs such as Eriocheir japonicus and E. sinensis or crayfish such as Cambaroides similis and C. dauricus. The final hosts other than man are dogs, cats, pigs, and wild animals. Paragonimiasis has been known to distribute widely over the south Korea, however, the prevalence among people and intermediate hosts is gradually decreasing in recent years. In Korean people, the lung fluke have caused pulmonary infections in a great many of cases but as well extrapulmonary ones including cerebral, spinal, subcutaneous, hepatic, splenic, abdominal, urinary, gynecologic, and other types. The definite diagnosis of paragonimiasis can be executed by the recovery of eggs from sputum or feces of patients, however, immunological methods such as intradermal test, complement-fixation test, precipitin reactions, immunofluorescent techniques, enzyme-linked immunosorbent assay (ELISA) are greatly helpful for egg-negative or extrapulmonary cases. Various drugs have been introduced for the treatment of paragonimiasis, and among them, bithionol, niclofolan and praziquantel have shown high therapeutic efficacy. The most recommendable one is considered praziquantel. For control of this disease, mass chemotherapy of patients seems to be the most efficient and feasible measure.

A case of chronic cerebral paragonimiasis westermani

“…Clinical symptoms of cerebral paragonimiasis include epilepsy (frequently Jacksonian type), headache, hemiplesia, monoplesia, hemiparesis, and aphasia. Visual disturbances are infrequently caused by basal arachnoiditis in the brain involvement (Choi, 1990). In the present case, it is suggested from the episodes of occasional seizure attacks that the patient could get along with the impaired cerebral lesions for about 30 years since he was contracted with the disease.…”

A Case of Incidentally Diagnosed Adrenal Paragonimiasis

“…It is also known to be widely distributed in Korea, although the prevalence is gradually decreasing [15]. With the possibility of developing extrapulmonary paragonimiasis, involvement of brain, spinal cord, subcutaneous tissue and urinary tract have been reported in Korea [15]. However, as the infestation of organs such as omentum and adrenal gland are less likely to produce definite symptoms, diagnosis of abdominal paragonimiasis may be difficult unless remarkable lesions are found by imaging studies.…”

“…The nationwide prevalence of human paragonimiasis in China was estimated to be 1.71% [14]. It is also known to be widely distributed in Korea, although the prevalence is gradually decreasing [15]. With the possibility of developing extrapulmonary paragonimiasis, involvement of brain, spinal cord, subcutaneous tissue and urinary tract have been reported in Korea [15].…”

Different Chest Radiographic Findings of Pulmonary Paragonimiasis in Two Endemic Countries

“…In Laos, the most frequently isolated species are P. heterotremus , P. harinasutai , and P. bangkokensis , 7 whereas in Korea, P. westermani , P. pulmonalis , and P. iloktsuenensis prevail. 8 The late access to healthcare in Laos may be another explanation. Some patients experienced symptoms for several years before admission, which consequently made cases in Laos more advanced.…”