Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042109 (urticaria)
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Paragonimiasis was diagnosed in eight patients: five with sputum specimens positive for characteristic ova and three with only stool specimens positive for ova. Clinical symptoms, roentgenograms and serologic findings appeared to correlate with severity of disease. All eight patients were treated with praziquantel (oral dose, 75 mg/kg of body weight daily for two consecutive days). Of seven patients who completed the treatment, six had ova-negative sputum and stool specimens by day 90; the seventh patient's specimens became ova negative by day 120. The eighth patient, who had failed to respond to prior treatment with bithionol, could not tolerate the daily dosage of 75 mg/kg because of nausea. Although he received the same total dose (150 mg/kg) over four days his specimens remained ova positive on day 90. Adverse effects included nausea (two patients), headache (one patient), and urticaria (two), the last effect possibly secondary to release of antigen from drug-damaged parasites. A review of the epidemiology, clinical presentation, and treatment of pulmonary paragonimiasis is presented.
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PMID:Paragonimiasis: diagnosis and the use of praziquantel in treatment. 400 15

Six species of Paragonimus have been reported in Thailand: P. siamensis in cat, bandicoot and rat; P. bangkokensis in mongoose; P. harinasutai in cat and dog (experiment); P. macrochis in bandicoot and rat; P. westermani in tiger and P. heterotremus in cat, dog and man. It is interesting to note that in 1965 two immature P. heterotremus worms were recovered for the first time in man, namely in subcutaneous swellings in a boy; in 1981 nine mature P. heterotremus worms were expectorated after praziquantel treatment. P. heterotremus has been postulated to be the main cause of human paragonimiasis in Thailand. The clinical manifestation of paragonimiasis heterotremus is similar to paragonimiasis westermani. In the 1960's and 1970's bithionol was used to treat paragonimiasis, the cure rate was only 50-60%, and side effects including urticaria, rash, abdominal pain, nausea, vomiting, diarrhoea and dizziness were common. In the past 4 years, niclofolan and praziquantel (2-cyclohexyl-carbonyl-1,2,3,6,7,11b-hexahydro - 4H - pyrazino [2,1-a]isoquinolin-4-one, EMBAY 8440, Biltricide) have been used. A single dose of 2 mg/kg body weight of niclofolan yielded 100% cure rate. Praziquantel at dosages of 3 X 25 mg/kg body weight daily for one day and two days gave 80% and 100% cure rates, respectively. The eggs disappeared in 2-3 weeks with improvement of symptoms and signs, but radiologically lesions took a few months or more to clear, depending on size and severity. Side effects in the niclofolan group were higher; in the praziquantel group side effects were minimal and no toxic effects were detected.
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PMID:Paragonimus heterotremus and other Paragonimus spp. in Thailand: pathogenesis, clinic and treatment. 654 91

Paragonimiasis is a zoonosis caused by many species of Paragonimus commonly P. westermani. Human get infected by eating raw, salted, pickled, smoked, partially cooked crustaceans (crayfish or crabs). Clinical manifestations ranges from non-specific symptoms like pain abdomen, diarrhea, urticarial rashes, fever to pleuropulmonary symptoms like cough, hemoptysis, chest pain and dyspnea. A 48 years, female presented at TUTH emergency with fever on and off for nine months, cough and shortness of breath for three months, lethargy, malaise and urticaria with history of raw crab intake one month prior to the onset of symptoms. Blood and pleural fluid analysis revealed raised total counts with eosinophilia and x-ray showed bilateral infiltration of lower lobes with pleural effusion. Diagnosis was confirmed by microscopic examination of sputum for Paragonimus. She responded well to Praziquantel. Pulmonary paragonimiasis must be considered in the differential diagnosis of unresolving pneumonia and unexplained hypereosinophilia.
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PMID:Unresolving Pneumonia with Pleural effusion: Pulmonary Paragonimiasis. 2874 28