eMedicine Specialties > Pediatrics: General Medicine > Parasitology

Paragonimiasis: Follow-up

Author: Jennifer Patterson, DO, Fellow, Department of Infectious Diseases, Cooper University Hospital, Robert Wood Johnson School of Medicine
Coauthor(s): Seth D Rosenbaum, MD, Attending Physician in Infectious Diseases, Medical Specialty Associates, PA; 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
Contributor Information and Disclosures

Updated: Apr 10, 2009

Follow-up

Further Inpatient Care

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

Further Outpatient Care

  • Follow up initial treatment after a few weeks.

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.

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.

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.

Patient Education

  • Safe food preparation and consumption must be emphasized.

Miscellaneous

Medicolegal Pitfalls

  • Failure to differentiate between paragonimiasis and tuberculosis
 


More on Paragonimiasis

Overview: Paragonimiasis
Differential Diagnoses & Workup: Paragonimiasis
Treatment & Medication: Paragonimiasis
Follow-up: Paragonimiasis
Multimedia: Paragonimiasis
References
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References

  1. Liu Q, Wei F, Liu W, Yang S, Zhang X. Paragonimiasis: an important food-borne zoonosis in China. Trends Parasitol. Jul 2008;24(7):318-23. [Medline].

  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].

  4. Rosen MJ. Chronic cough due to tuberculosis and other infections: ACCP evidence-based clinical practice guidelines. Chest. Jan 2006;129(1 Suppl):197S-201S. [Medline].

  5. Robertson KB, Janssen WJ, Saint S, Weinberger SE. Clinical problem-solving. The missing piece. N Engl J Med. Nov 2 2006;355(18):1913-8. [Medline].

  6. Tsang KW, File TM Jr. Respiratory infections unique to Asia. Respirology. Nov 2008;13(7):937-49. [Medline].

  7. 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].

  8. Anonymous. Drugs for parasitic infections. Med Lett Drugs Ther. Aug 2004;46(1189):1-12.

  9. Blair D, Xu ZB, Agatsuma T. Paragonimiasis and the genus Paragonimus. Adv Parasitol. 1999;42:113-222. [Medline].

  10. Christie JD, Garcia LS. Emerging parasitic infections. Clin Lab Med. Sep 2004;24(3):737-72. [Medline].

  11. 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].

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

  13. Kagawa FT. Pulmonary paragonimiasis. Semin Respir Infect. Jun 1997;12(2):149-58. [Medline].

  14. 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.

  15. 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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Further Reading

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Keywords

paragonimiasis, Paragonimus, Paragonimus westermani, P westermani, Oriental lung fluke, parasitic infection, trematodes, paragonimiasis, inflammation of the lung, treatment, diagnosis, pneumonia, bronchitis, bronchiectasis, bronchitis, bronchiectasis, pleural effusion, empyema, abdominal pain, diarrhea, urticaria, facial palsy, seizures, optic atrophy, hematuria, hernia

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Contributor Information and Disclosures

Author

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.

Coauthor(s)

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.

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.

Medical Editor

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: GlaxoSmithKline Honoraria Speaking and teaching; MedImmune Honoraria Speaking and teaching; Merck Honoraria Speaking and teaching; sanofi pasteur Honoraria Speaking and teaching

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Leslie L Barton, MD, Professor, Program Director, Department of Pediatrics, University of Arizona School 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.

CME Editor

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: GlaxoSmithKline Honoraria Speaking and teaching; MedImmune Honoraria Speaking and teaching; Merck Honoraria Speaking and teaching; sanofi pasteur 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: None None None

 
 
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