• Parasites, Hosts and Diseases
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• v.60 no.5
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• pp.353-355
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• 2022

We report a case of an 80-year-old Korean man with chronic cerebral paragonimiasis who presented with progressive memory impairment. He suffered from pulmonary paragonimiasis 60 years ago and has been experiencing epilepsy since the age of 45. He began experiencing memory and cognitive deterioration 3 years ago. He visited the neuropsychiatric department of our hospital to check his symptoms and health from a year ago. Contrast-enhanced brain magnetic resonance imaging study revealed calcifications and cystic lesions encompassing the right temporo-occipital region. Encephalomalatic changes were also observed in the right occipital and temporal areas. The anti-Paragonimus specific IgG antibodies in his serum showed a strong positive response. The neuropsychological test results showed a Global Deterioration Scale of 4 and a Clinical Dementia Rating Scale of 1. The chronic cerebral paragonimiasis lesions in the patient's right temporo-occipital region might induce the dementic change.

• Clinical and Experimental Pediatrics
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• v.51 no.7
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• pp.760-765
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• 2008

Paragonimiasis is a parasitic infection that occurs following the ingestion of infectious Paragonimus metacercariae from crabs or crayfish. Pulmonary paragonimiasis is the most common clinical manifestation of this infection, but several ectopic paragonimiasis cases have also been reported. Among them, cases of subcutaneous paragonimiasis are rare, especially in children. We report a case of subcutaneous paragonimiasis of the right abdominal wall with pleural effusion with hepatic involvement and without abnormal pulmonary infiltration in a boy aged 2 years and 5 months. He had eaten soybean sauce-soaked freshwater crabs (kejang) 6 months prior to complaining of right abdominal wall distension. On evaluation, right pleural effusion without abnormal pulmonary infiltration was detected, as well as blood eosinophilia, an elevated serum IgE level, pleural fluid eosinophilia and a positive enzyme-linked immunosorbent assay that detected P. westermani antibody in the serum. Thoracentesis, praziquantel administration, and excision of subcutaneous lesions were performed. After treatment, the eosinophil count and serum IgE level were decreased, and the subcutaneous lesions did not recur. The frequency of paragonimiasis has decreased recently, but it is still prevalent in Korea. Paragonimiasis should be suspected if pleural fluid eosinophilia is associated with blood hypereosinophilia and a high level of serum IgE; however clinicians should obtain a thorough history of travel and food habits.

• Tuberculosis and Respiratory Diseases
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• v.66 no.6
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• pp.451-456
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• 2009

Paragonimiasis is a parasitic infection that occurs following the ingestion of infectious Paragonimus metacercariae, which occurs as a result of eating raw or undercooked freshwater crabs or crayfish. Pulmonary paragonimiasis is the most common clinical manifestation of this infection. Human paragonimiasis occurs sporadically. We experienced a case of pulmonary paragonimiasis in a 35-year-old woman with left lower chest pain. The patient had hypereosinophilia and a pleural effusion. The diagnosis was confirmed by positive ELISA (Enzyme-linked immunosorbent assay) that detected Paragonimiasis westermani antibody in the serum. We treated the patient with praziquantel for two days at a daily dosage of 75 mg/kg. Left pleuritic pain and pleural effusion improved after treatment. However, similar symptoms and pleural effusion developed recurrently for the first 3 courses of treatment with praziquantel. Upon the fourth round of treatment, the patient made a full recovery.

• Pediatric Infection and Vaccine
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• v.9 no.2
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• pp.222-229
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• 2002

Human infection with the lung fluke Paragonimus westermani has become rare in Korea. Human paragonimiasis is caused by eating raw fresh-water crayfishes or crabs infected with larval metacercariae. Recently, we experienced three cases of pulmonary paragonimiasis in a family. They ate raw fresh-water crayfishes that lived in a stream in Wolchulmountain. All the parients had hypereosinophilia and pulmonary infiltrates with pleural effusion or hydropneumothorax, which did not improve on antibiotics. Ingestion of raw crayfishes was a clue for paragonimiasis. Positive results were shown both on intradermal skin test and ELISA for Paragonimus westermani specific IgG. After treatment with praziquantel, the patients showed an improvement. This is the first familial human paragonimiasis, reported from Wolchulmountain in Chonnam Province where there had been no previous cases of paragonimiasis.

• Tuberculosis and Respiratory Diseases
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• v.40 no.3
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• pp.274-282
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• 1993

Background: Pulmonary paragonimiasis is caused by consumption of raw or improperly cooked crabs infected by a laval stage (metacercaris) of the parasite. In our country it had been a highly prevalent endemic disease until th late 1960s, and after then it's prevalence has been markedly decreased. But because some people have continued to ingest undercooked crabs, this disease have yet occured sporadically. Methods: We reviewed the clinical and radiological findings retrospectively in seventy-four patients of pulmonary paragonimiasis including familial infestation in 7 familes (20 cases) who were confirmed by food history, clinical and radiological findings, and labaratory data. Results: The male: female ratio was 2.2:1 and most prevalent age was 40-49 years old. Twen6ty nine patients (39%) had ova-positive infection. The detection sites were sputum (48%), pleural fluid (17%), fine needle aspiration biopsy of nodular or cystic lesion (17%), pleural biopsy (7%), skin nodule biopsy (7%), and stool (3%). The patients had pulmonary symptoms in 63 cases (85%) but 9 cases did not have any symptoms. The 53 cases (72%) had abnormal radiological findings in lung parenchyme (75%) and pleura (63%). However 21 cases (28%) showed no specific findings in their chest X-ray. Serum titers (ELISA) of specific IgG for paragonimiasis in 13 cases were followed for average 9.8 months after treatment, which showed slow decreasement. In the evaluation of family member (7 family, 20 cases), all members having the common dietary history together with a proven patients were confirmed this disease by serological test, regardless of the presence or the abscence of clinical or radilogical symptoms. Conclusion: We evaluated the clinical and radiological findings in 74 cases of pulmonary paragonimiasis including 7 family members who had a history of ingestion of improperly cooked crabs together with patients. The paients of pulmonary paragonimiasis have various findings in clinical and radiological findings. Common diet exposure history and laboratory findings including specific IgG were important in earlier diagnosing and treating in family members of patients.

• Journal of Chest Surgery
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• v.47 no.6
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• pp.572-572
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• 2014

• Tuberculosis and Respiratory Diseases
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• v.77 no.4
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• pp.178-183
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• 2014

Here, we report a case of pulmonary paragonimiasis that was improved with initial anti-tuberculosis (TB) therapy but confused with reactivated pulmonary TB. A 53-year-old Chinese female presented with a persistent productive cough with foul smelling phlegm and blood streaked sputum. Radiologic findings showed subpleural cavitary consolidation in the right upper lobe (RUL). Bronchoscopic and cytological examination showed no remarkable medical feature. She was diagnosed with smear-negative TB, and her radiologic findings improved after receiving a 6-month anti-TB therapy. The chest CT scans, however, obtained at 4 months after completion of anti-TB therapy showed a newly developed subpleural consolidation in the RUL. She refused pathologic confirmation and was re-treated with anti-TB medication. Nevertheless, her chest CT scans revealed newly developed cavitary nodules at 5 months after re-treatment. She underwent thoracoscopic wedge resection; the pathological examination reported that granuloma caused by Paragonimus westermani. Paragonimiasis should also be considered in patients assessed with smear-negative pulmonary TB.

• Journal of Chest Surgery
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• v.1 no.1
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• pp.19-24
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• 1968

A clinical investigation was reported on 17 cases of spontaneous pneumothorax requiring surgical mana-gement. Males outnumbered females 15:2. Determination of the etiology in this series showed that the majority were pulmonary tuberculosis and paragonimiasis. Several others had pneumonia, lung abscess, cyst and blebs. It is of particular interest that the acute inflammation of respiratory system was younger age group, pulmonary tuberculosis & paragonimiasis were between 2 nd and 3 rd decades, and lung abscess, cyst, blebs were above 4 th decade. Pulmonary tuberculosis was far advanced bilateral and active. The ratio of right to left side was 13:6 and both side involved in 2 cases. In about half cases of patients, above 50%-collapsed lung associated with mediastinal shifting developed. The complications were pleural effusion and bronchopleural fistula. The former was 13 cases [76.4%] in which 3 cases combined with mixed infection, and latter was 5 cases. As the management, 11 cases were subjected to intercostal or rib resection drainage with continuous suc-tion. Among 11 drainage cases, 8 cases were successful in acute stage and 3 cases failed in chronic stage. This faiure was due to interference with re-expansion of collapsed lung for peel formation and broncho-pleural fistula. The open thoractomy was applied in 9 cases, among which primary operation were 5 cases and drainage failure were 4 cases. Among 11 cases subjected to the open thoracotomy, wedged resection was performed in 3 cases including paragonimiatic cyst, and pneumonectomy in 1 case-tuberculosis, and decortication only was performed in 2 cases in paragonimiasis. Decortication & lung resection was carried out in 2 patients among which ruptured lung abscess 1 case and ruptured multiple blebs 1 case. There was no case of death but prognosis of the tuberculosis may be poor because of far advanced bilateral and active pulmonary tuberculosis.

• Pediatric Infection and Vaccine
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• v.24 no.3
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• pp.178-182
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• 2017

Paragonimiasis was one of the most common causes of cavitary lung lesions until the 1960s, but now it has become a very rare disease in Korea. A 16-year-old boy presented with hemoptysis and several days of cough. His plain chest radiograph showed nodular opacity with a cavity in the left upper lung region. Although his symptoms disappeared after taking antituberculous drugs, his plain chest radiograph and computed tomography images after completion of therapy showed a new nodule with a cavity in the left lung field. Through video-assisted thoracoscopic wedge resection, Paragonimus eggs were found in the lung tissues.

• Journal of Chest Surgery
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• v.47 no.6
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• pp.573-573
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• 2014