References:
- Global Infectious Diseases and Epidemiology Online Network: Infectious Diseases of the Philippines, 2013 eBook Edition, ISBN 978-1-61755-582-4, by Stephen Berger. Accessed here.
| Agent | PARASITE - Platyhelminthes, Trematoda. Paragonimus westermani, P. heterotremus, P. skrjabini, P. miyazakii, P. africanus, et al. |
| Reservoir | Human Dog Cat Pig Wild carnivore Snail (Semisulcospira, Thiara, etc.) |
| Vector | None |
| Vehicle | Fres-water crab (at least 8 species) Crayfish (Cambaroides) |
| Incubation Period | 6 weeks to 6 months |
| Diagnostic Tests | Identification of ova in sputum or stool Serologic and skin tests are available |
| Typical Adult Therapy | Praziquantel 25 mg/kg TID X 2d. OR Bithionol 40 mg/kg every other day X 10 doses. OR Triclabendazole 10 mg/kg/d X 2 |
| Typical Pediatric Therapy | As for adult |
| Clinical Hints | Pulmonary infection with bloody or “rusty” sputum, central nervous system disease (eg, meningitis or seizures) and eosinophilia; subcutaneous nodules occasionally observed; parasite may survive for decades in human host. |
| Synonyms | Alaria, Endemic hemoptysis, Lung fluke, Oriental lung fluke, Paragonimus, Poikilorchis, Pulmonary distomiasis. |
The acute phase of parasitic invasion and migration is accompanied by diarrhea, abdominal pain, fever, urticaria, hepatosplenomegaly, wheezing, cough, pleuritic pain, and eosinophilia or hypereosinophilia.
- Later, pulmonary manifestations include cough, expectoration of discolored sputum, hemoptysis, and chest roentgenographic abnormalities.
- Pulmonary infection may mimic lung cancer, both clinically and radiologically
- Paragonimiasis is a common cause of persistent pleural effusion in endemic regions; such collections may suggest the diagnosis of chylothorax.
- Extrapulmonary infection may involve the brain (less than 1% of cases), epidural space, subcutaneous tissues (most commonly the trunk and thighs), hepatobiliary system, colon or other organs.
- Subcutaneous disease is found in 10% of patients with P. westermani infection, and 20% to 60% of those with P. skrjabini (P. szechuanensis) infection.
- Rare instances of disseminated infection with septic shock have been reported.