Paragonimiasis Follow-up

  • Author: Seth D Rosenbaum, MD; Chief Editor: Russell W Steele, MD   more...
 
Updated: Mar 13, 2012
 

Further Inpatient Care

  • Patients with cerebral paragonimiasis may require care in an ICU for seizures and/or coma.
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Further Outpatient Care

  • Follow up initial treatment after a few weeks.
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Deterrence/Prevention

  • In endemic areas, avoid eating uncooked or insufficiently cooked crustaceans and raw pork. Individuals should also refrain from using uncooked crustacean juice medicinally and for seasoning.
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Complications

  • Pulmonary complications include pneumonia, bronchitis, bronchiectasis, lung abscess, pleural effusion, and empyema.
  • Cerebral complications include seizures and coma.
  • Skin complications include migratory allergic skin lesions.
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Prognosis

  • The prognosis is good, with therapeutic cure rates between 90 and 100%.
  • Symptoms resolve rapidly, and eggs disappear from the sputum in a few weeks following treatment. (Pulmonary paragonimiasis may be self-limited, with lesions resolving in 5-10 years in light infections.)
  • Resolution of abnormalities on chest radiographs may take several months, depending on the chronicity of the disease.
  • Cerebral infections may be associated with persistent seizures.
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Patient Education

  • Safe food preparation and consumption must be emphasized.
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Contributor Information and Disclosures
Author

Seth D Rosenbaum, MD  Attending Physician in Infectious Diseases, Medical Specialty Associates, PA

Seth D Rosenbaum, MD is a member of the following medical societies: American College of Physicians, American Medical Association, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Coauthor(s)

Jennifer Patterson, DO  Fellow, Department of Infectious Diseases, Cooper University Hospital, Robert Wood Johnson School of Medicine

Jennifer Patterson, DO is a member of the following medical societies: American Osteopathic Association

Disclosure: Nothing to disclose.

Annette C Reboli, MD  Professor of Medicine, University of Medicine and Dentistry of New Jersey; Head, Division of Infectious Diseases, Department of Medicine, Cooper University Hospital and University Medical Center

Annette C Reboli, MD is a member of the following medical societies: Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Robert W Tolan Jr, MD  Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine

Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility

Disclosure: Novartis Honoraria Speaking and teaching

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Leslie L Barton, MD  Professor Emerita of Pediatrics, University of Arizona College of Medicine

Leslie L Barton, MD is a member of the following medical societies: American Academy of Pediatrics, Association of Pediatric Program Directors, Infectious Diseases Society of America, and Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Robert W Tolan Jr, MD  Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine

Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility

Disclosure: Novartis Honoraria Speaking and teaching

Chief Editor

Russell W Steele, MD  Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association

Disclosure: Nothing to disclose.

References

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  2. Boe DM, Schwarz MI. A 31-year-old man with chronic cough and hemoptysis. Chest. Aug 2007;132(2):721-6. [Medline].

  3. Vidamaly S, Choumlivong K, Keolouangkhot V, Vannavong N, Kanpittaya J, Strobel M. Paragonimiasis: a common cause of persistent pleural effusion in Lao PDR. Trans R Soc Trop Med Hyg. Jan 29 2009;[Medline].

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  10. Kyung SY, Cho YK, Kim YJ, Park JW, Jeong SH, Lee JI, et al. A paragonimiasis patient with allergic reaction to praziquantel and resistance to triclabendazole: successful treatment after desensitization to praziquantel. Korean J Parasitol. Mar 2011;49(1):73-7. [Medline]. [Full Text].

  11. Calvopina M, Guderian RH, Paredes W, Chico M, Cooper PJ. Treatment of human pulmonary paragonimiasis with triclabendazole: clinical tolerance and drug efficacy. Trans R Soc Trop Med Hyg. Sep-Oct 1998;92(5):566-9. [Medline].

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  15. Dainichi T, Nakahara T, Moroi Y, et al. A case of cutaneous paragonimiasis with pleural effusion. Int J Dermatol. Sep 2003;42(9):699-702. [Medline].

  16. Hawn TR, Jong EC. Update on Hepatobiliary and Pulmonary Flukes. Curr Infect Dis Rep. Dec 1999;1(5):427-433. [Medline].

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  18. Maguire JH. Trematodes (Schistosomes and other Flukes). In: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. Vol 2. 6th ed. Philadelphia, PA: Churchill Livingstone; 2004:3283-4.

  19. Nakamura-Uchiyama F, Mukae H, Nawa Y. Paragonimiasis: a Japanese perspective. Clin Chest Med. Jun 2002;23(2):409-20. [Medline].

 
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This micrograph depicts an egg from the trematode parasite Paragonimus westermani. Eggs range in size from 68-118 µm x 39-67 µm. They are yellow-brown and ovoidal or elongated, with a thick shell. They are often asymmetrical, with one end slightly flattened. At the large end, the operculum (ie, lid or covering) is visible. Photo courtesy of The Centers for Disease Control and Prevention.
This is an illustration of the life cycle of Paragonimus westermani, one of the causal agents of paragonimiasis. Photo courtesy of The Centers for Disease Control and Prevention.
 
 
 
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