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Query: UMLS:C0010200 (cough)
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The first case of cerebral paragonimiasis was reported by Otani in Japan in 1887. This was nine years after Kerbert's discovery of the fluke in the lungs of Bengal tigers and seven years after a human pulmonary infection by the fluke was demonstrated by Baelz and Manson. The first case was a 26-year-old man who had been suffering from cough and hemosputum for one year. The patient developed convulsive seizures with subsequent coma and died. The postmortem examination showed cystic lesions in the right frontal and occipital lobes. An adult fluke was found in the occipital lesion and another was seen in a gross specimen of normal brain tissue around the affected occipital lobe. Two years after Otani's discovery, at autopsy a 29-year-old man with a history of Jacksonian seizure was reported as having cerebral paragonimiasis. Some time later, however, it was confirmed that the case was actually cerebral schistosomiasis japonica. Subsequently, cases of cerebral paragonimiasis were reported. However, the majority of these cases were not confirmed histologically. It was pointed out that some of these early cases were probably not Paragonimus infection. After World War II, reviews as well as case reports were published. Recently, investigations have been reported from Korea, with a clinicla study on 62 cases of cerebral paragonimiasis seen at the Neurology Department of the National Medical Center, Seoul, between 1958 and 1964. In 1971 Higashi described a statistical study on 105 cases of cerebral paragonimiasis that had been treated surgically in Japan.
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PMID:Cerebral Paragonimiasis. 109 92

Patients with Paragonimiasis westermani show a typical ring form or nodular shadow on chest X-ray, cough, sputum, and hemosputum. Recently, case reports of Paragonimiasis westermani, accompanied by pneumothorax and pleural effusion, as for Paragonimiasis miyazakii, have been increasing. Paragonimus westermani often causes an ectopic infection in various organs such as the peritoneal cavity, pleural cavity, pericardium, liver, adrenal gland and brain. Cutaneous paragonimiasis is considered one of the typical forms of ectopic infection in its earlier phase, but a few unexpected cases of cutaneous Paragonimiasis westermani have also been reported. A 68-year old man, who had never eaten fresh-water crab or raw sliced meat of wild boar, noticed subcutaneous induration of the abdominal wall. The induration had been gradually moving upwards and to the right from the infraumbilical region for over 20 days, and then disappeared at the right upper lateral abdominal wall. Eight months later, he developed severe pain in the right lower chest, and a chest X-ray showed right pleural effusion. Laboratory examinations revealed eosinophilia (WBC 3940/mm3, eosinophil 9%), elevated ESR, and an elevated serum total IgE level (5517 IU/ml). Ouchterlony's double diffusion test performed with the patient's serum in agarose showed strong bands toward Paragonimus westermani antigen, compared to Paragonimus miyazakii antigen. Immunoelectrophoresis with the patient's serum showed specific bands toward Paragonimus westermani antigen. This patient was finally diagnosed as having Paragonimiasis westermani infection, and he responded to praziquantel administration. The clinical course of this patient appears to be rare in cases of Paragonimiasis westermani infection. The clinical course of this case resembled some cases of Paragonimiasis miyazakii infection.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of Paragonimiasis westermani with pleural effusion eight months after migrating subcutaneous induration of the abdominal wall]. 138 80

Miyazaki Prefecture has long been known as one of the endemic areas of paragonimiasis westermani. The prevalence of this disease peaked around 1956 and then drastically decreased. A few sporadic cases are still occasionally found in Miyazaki Prefecture; however, the number of new cases has gradually increased during the last 5 years. One important point to be noted is the change of clinical manifestations in the patients. A classically known form of paragonimiasis westermani is characterized by persisting cough, bloody sputum, and nodular or ring shadows in the lung field by chest x-ray. However, the patients recently found in Miyazaki Prefecture rarely showed such typical symptoms. Only four of 13 cases were found to have pulmonary infiltration and nine cases showed massive pleural effusion without pulmonary infiltration. Such atypical cases may be caused by low intensity of infection or, alternatively, be due to the earlier diagnosis.
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PMID:Recent trends of paragonimiasis westermani in Miyazaki Prefecture, Japan. 182 22

Oral administration of 25 mg of praziquantel/kg of body weight 3 times a day for 2 consecutive days resulted in clinical and parasitologic cure of paragonimiasis in a dog. Previous treatment with the drug at the dosage recommended for cestode removal (5 mg/kg, SC) for 2 days was only partially effective. The dog exhibited cachexia, coughing, gagging, and occasional hemoptysis. Radiography revealed nodular and cystic densities in the lungs. The life history and clinical aspects of Paragonimus kellicotti infection in the dog are briefly reviewed.
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PMID:Paragonimiasis in a dog: treatment with praziquantel. 401 5

An operated case of cerebral paragonimiasis miyazakii was reported. A 25-year-old man was admitted to our hospital on Jan. 25, 1982, because of weakness, sensory disorder and focal convulsion of the right upper limb. He complained of slight headache but had no sign of meningeal irritation nor inflammation. CT scan revealed a left parietal low density mass with irregular ring-like contrast enhancement. Left carotid angiogram showed stretched arteries around the mass. Laboratory findings were normal except for eosinophilie (17%). Chest X-P was normal. Operation was performed under diagnosis of glioblastoma on Aug. 6, 1982. The tumor was well-circumscribed and had a firm capsule which containing necrotic substance. The tumor was removed totally and the bone flap was also removed since slight brain swelling was seen. Histologically it proved to be a granuloma and four eggs of helminth were found in the necrotic tissue. Post operative state of the patient was satisfactory and cranioplasty was performed 3 weeks later. On Aug. 31, he began to complain of chest pain, cough and hemosputum, and chest X-P disclosed a nodular shadow in the lower lobe of the right lung. Paragonimiasis was strongly suspected because he had a history of having three fresh-water crabs (Potamon dehaani) 18 months before. But not egg was found in either sputum nor stool. Skin test with paragonimus westermani antigen was highly positive.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Surgical treatment of cerebral paragonimiasis miyazakii]. 648 96

A patient from Southeast Asia with cough and hemoptysis was documented to have pulmonary paragonimiasis. Initial treatment with bithionol failed. The patient was then treated with praziquantel 75 mg/kg body weight a day for 2 days under an investigational protocol. Subsequent follow-up studies showed clinical improvement and indicated parasitologic cure. A concurrent asymptomatic Clonorchis infection was also cured following praziquantel treatment. Side effects were minor.
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PMID:Successful praziquantel treatment of paragonimiasis following bithionol failure. A case report. 665 Jul 33

Nine cases of paragonimiasis have been encountered in Laotian Hmong immigrants from Camp Ban Vinai in Thailand. Symptoms included cough, hemoptysis, and fever. Chest x-ray films showed segmental infiltrates and pleural effusions, often bilateral. The clinical presentation mimics tuberculosis. All Hmong patients with chronic infiltrates and pleural disease in whom tuberculosis has not been proven should have parasitologic and serologic evaluation to exclude paragonimiasis.
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PMID:Paragonimiasis in the United States. A report of nine cases in Hmong immigrants. 709 46

The hepatic damage induced by Paragonimus skrjabini, and the migration route of this species and that of P. westermani, were investigated in a series of animal experiments and in 34 clinical and four autopsy cases of paragonimiasis. The major symptoms and signs of an unique case reported from Sichuan Province included hepatic tenderness, disturbance of hepatic functions, remittent fever, and cough with bloody sputum. Laparotomy revealed marked adhesions surrounding the liver, spleen and duodenum. Diagnosis was made by finding P. skrjabini in a bulla on the abdominal wall about 5 months after the onset of illness. After specific treatment with bithional, body temperature and liver functions returned to normal. Twenty-three of 33 cases independently studied from Fujian Province also showed similar hepatic function disturbance. Autopsy cases showed hepatic chronic eosinophilic abscesses with Charcot-Leyden crystals. Experimentally, P. skrjabini infection caused hepatic damage in all laboratory animals used. The main pathologic changes were initially acute eosinophilic abscesses in the liver, worms being found sometimes in the necrotic cavities of the abscesses; hepatomagaly also occurred. Some cysts containing mature worms were found in the liver of dogs 3-9 months after infection. Numerous eggs were deposited in the cyst walls. The migration route of P. skrjabini was studied in young dogs. Worms appeared in the liver initially on day 3 and reached their highest level on day 14. P. westermani also migrated into liver, but their numbers were less than those of P. skrjabini.
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PMID:Hepatic damage in experimental and clinical paragonimiasis. 714 1

A case of paragonimiasis with a tumor of intrathoracic chest wall was reported. The patient was a 46-year-old male who complained of cough and showed abnormal findings on chest X-ray. After performing various examinations, the patient was diagnosis as having a tumor of the intrathoracic chest wall. On surgery, the tumor was enveloped in a thick capsule and its lumen was filled with yellow-white atheromatous material. Calcification was not found. Pathologically, an egg-like structure of a parasite was confirmed inside the sequestrum attached to the lining of the inner surface of the capsule. Past history of pleuritis and ingestion of freshwater crabs confirmed the diagnosis of paragonimiasis.
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PMID:[A case of paragonimiasis with a tumor of the intrathoracic chest wall]. 796 67

A 68-year-old woman and her 28-year-old son ate some rare fresh-water crabs (Eriocheir japonicus). The son became ill one month later with pleural effusion. After 10 months the mother's symptoms included cough, hemosputum and a nodular shadow on her chest X-ray. Eosinophilia was present and the Ouchterlony test showed strong bands toward Paragonimus westermani antigen in both patients. They were diagnosed as having Paragonimiasis westermani. The symptoms stopped after Bithionol administration and the bands of the Ouchterlony test also disappeared. The difference in the latent stage and clinical symptoms of these patients, who were infected at the same time, is interesting as it highlights the importance of observing other people who may have been infected with Paragonimus westermani.
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PMID:[Two cases of Paragonimus westermani in one family]. 808 4


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