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Section 3. Summaries of Infectious Diseases
Paragonimiasis
Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
CLINICAL MANIFESTATIONS: The disease has an insidious onset
and a chronic course. The 2 major forms of paragonimiasis described
are (1) pulmonary disease; and (2) extrapulmonary disease, which
results in a larval migrans syndrome. Pulmonary disease is associated
with chronic cough and dyspnea, but most infections probably
are inapparent or result in mild symptoms. Heavy infestations
cause paroxysms of coughing, which often produce blood-tinged
sputum that is brown because of the presence of
Paragonimus species eggs. Hemoptysis can be severe. Pleural effusion, pneumothorax,
bronchiectasis, and pulmonary fibrosis with clubbing can develop.
Extrapulmonary manifestations also may involve the liver, spleen,
abdominal cavity, intestinal wall, intraabdominal lymph nodes,
skin, and central nervous system, with meningoencephalitis,
seizures, and space-occupying tumors attributable to invasion
of the brain by adult flukes, usually occurring within a year
of pulmonary infection. Symptoms tend to subside after approximately
5 years but can persist for as many as 20 years.
Extrapulmonary paragonimiasis is associated with migratory allergic subcutaneous nodules containing juvenile worms. Pleural effusion is common, as is invasion of the brain.
ETIOLOGY: In Asia, classical paragonimiasis is caused by
Paragonimus westermani and
Paragonimus heterotremus adult flukes and their
eggs. The adult flukes of
P westermani are up to 12 mm long
and 7
. . . [Go to Full Text]
Related text in Red Book:
- Drugs for Parasitic Infections
Red Book
2006: 790-820.
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