The Korean journal of internal medicine

  • 제30권1호
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  • Pages.56-61
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  • 2015
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  • 1226-3303(pISSN)
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  • 2005-6648(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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Pleural fluid characteristics of pleuropulmonary paragonimiasis masquerading as pleural tuberculosis

  • Hwang, Ki-Eun (Department of Internal Medicine, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine) ;
  • Song, Hyo-Yeop (Department of Internal Medicine, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine) ;
  • Jung, Jae-Wan (Department of Internal Medicine, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine) ;
  • Oh, Su-Jin (Department of Internal Medicine, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine) ;
  • Yoon, Kwon-Ha (Department of Radiology, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine) ;
  • Park, Do-Sim (Department of Laboratory Medicine, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine) ;
  • Jeong, Eun-Taik (Department of Internal Medicine, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine) ;
  • Kim, Hak-Ryul (Department of Internal Medicine, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine)
  • 투고 : 2014.03.24
  • 심사 : 2014.07.10
  • 발행 : 2015.01.01
⟨ 이전 논문 다음 논문 ⟩

초록

Background/Aims: Pleuropulmonary paragonimiasis produces no specific symptoms or radiologic findings, allowing for the possibility of misdiagnosis. We evaluated the specific clinical and pleural fluid features of pleuropulmonary paragonimiasis masquerading as pleural tuberculosis. Methods: We retrospectively analyzed the clinical and radiologic characteristics of 20 patients diagnosed with pleuropulmonary paragonimiasis between 2001 and 2011. Results: In total, 17 patients presented with respiratory symptoms, including dyspnea (30%), hemoptysis (20%), cough (20%), and pleuritic chest pain (15%). Chest radiographs revealed intrapulmonary parenchymal lesions, including air-space consolidation (30%), nodular opacities (20%), cystic lesions (15%), ground-glass opacities (10%), and pneumothorax (5%). A pleural f luid examination revealed eosinophilia, low glucose levels, and high lactate dehydrogenase (LDH) levels in 87%, 76%, and 88% of the patients, respectively. These traits helped to distinguish pleuropulmonary paragonimiasis from other pleural diseases such as parapneumonic effusion, malignancy, and pleural tuberculosis. Conclusions: Pleuropulmonary paragonimiasis is often initially misdiagnosed as other pleural diseases. Therefore, it is important to establish the correct diagnosis. In patients with unexplained pleural effusion living in paragonimiasis-endemic areas, pleural fluid obtained by thoracentesis should be examined to distinguish pleuropulmonary paragonimiasis. When marked eosinophilia, high LDH levels, and low glucose levels are identified in pleural fluid, physicians could consider a diagnosis of pleuropulmonary paragonimiasis.

키워드

과제정보

연구 과제 주관 기관 : Ministry of Health and Welfare

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  3. Paragonimiasis in Children in Southwest China : A retrospective case reports review from 2005 to 2016 vol.96, pp.25, 2017, https://doi.org/10.1097/md.0000000000007265
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  8. Retrospective study of pleural parasitic infestations: a practical diagnostic approach vol.19, pp.None, 2015, https://doi.org/10.1186/s12879-019-4179-9
  9. Identification of pulmonary paragonimiasis using Ziehl-Neelsen stain vol.8, pp.1, 2015, https://doi.org/10.4168/aard.2020.8.1.36