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Section 3. Summaries of Infectious Diseases
Paragonimiasis
Clinical ManifestationsEtiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
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CLINICAL MANIFESTATIONS
There are 2 major forms of paragonimiasis: 1) disease attributable to Paragonimus westermani and Paragonimus heterotremus, causing primary pulmonary disease with or without extrapulmonary manifestations; and 2) disease attributable to other species of Paragonimus, for which humans are accidental hosts and manifestations generally are extrapulmonary, resulting in a larva migrans syndrome. The disease has an insidious onset and a chronic course. 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 liver, spleen, abdominal cavity, intestinal wall, intra-abdominal 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.
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ETIOLOGY
In Asia, classical paragonimiasis is caused by P
Related Article
Red Book 2009 2009: 783-816.