Paragonimiasis: A missed diagnosis from Nepal
Paragonimiasis, or Oriental lung fluke is a parasitic infestation seen in Asia, Africa and South America which is spread by the consumption of crabs and crayfish. To date four cases have been reported from Nepal. Here, we report a case of paragonimiasis in a young male from Kathmandu valley who pres...
Main Authors: | , |
---|---|
Format: | Article |
Language: | English |
Published: |
Elsevier
2020-01-01
|
Series: | Respiratory Medicine Case Reports |
Subjects: | |
Online Access: | http://www.sciencedirect.com/science/article/pii/S2213007120305128 |
id |
doaj-59434791bf164483be462975cdc92a03 |
---|---|
record_format |
Article |
spelling |
doaj-59434791bf164483be462975cdc92a032020-12-17T04:48:58ZengElsevierRespiratory Medicine Case Reports2213-00712020-01-0131101298Paragonimiasis: A missed diagnosis from NepalShreya Shrivastav0Anamika Jha1Department of Pathology, Tribhuvan University Teaching Hospital, Institute of Medicine, Maharajgunj, PO Box 1524, 44600, Nepal; Corresponding author.Department of Radiology, Tribhuvan University Teaching Hospital, Institute of Medicine, NepalParagonimiasis, or Oriental lung fluke is a parasitic infestation seen in Asia, Africa and South America which is spread by the consumption of crabs and crayfish. To date four cases have been reported from Nepal. Here, we report a case of paragonimiasis in a young male from Kathmandu valley who presented with symptoms of fever, on and off for 1 month, shortness of breath and cough. He was found to have pleural effusion. Sputum examination did not reveal acid fast bacilli, However, based on clinical features, he was started on antitubercular treatment. There was initial improvement, but later, he continued to have cough and hemoptysis over the next 2 years and on subsequent High-Resolution Computerized Tomography (HRCT) he was found to have a cavitary lung lesion in the superior segment of lower lobe of left lung. A possibility of aspergillosis was considered for which he underwent a lobectomy. The gross examination of the lung showed a small cavity measuring 5 mm which revealed on histology a parasitic structure with serous glands within it. In addition, there were many foreign body granulomas with ova within them. A diagnosis of paragonimiasis was made and the patient was started on Praziquantal. He recovered well and is currently asymptomatic. We can learn from this case that the signs and symptoms of paragonimiasis mimic that of tuberculosis and the mistaken diagnosis can lead to unnecessary treatment, prolonged morbidity and loss of time and resources.http://www.sciencedirect.com/science/article/pii/S2213007120305128ParagonimiasisTuberculosisNepal |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Shreya Shrivastav Anamika Jha |
spellingShingle |
Shreya Shrivastav Anamika Jha Paragonimiasis: A missed diagnosis from Nepal Respiratory Medicine Case Reports Paragonimiasis Tuberculosis Nepal |
author_facet |
Shreya Shrivastav Anamika Jha |
author_sort |
Shreya Shrivastav |
title |
Paragonimiasis: A missed diagnosis from Nepal |
title_short |
Paragonimiasis: A missed diagnosis from Nepal |
title_full |
Paragonimiasis: A missed diagnosis from Nepal |
title_fullStr |
Paragonimiasis: A missed diagnosis from Nepal |
title_full_unstemmed |
Paragonimiasis: A missed diagnosis from Nepal |
title_sort |
paragonimiasis: a missed diagnosis from nepal |
publisher |
Elsevier |
series |
Respiratory Medicine Case Reports |
issn |
2213-0071 |
publishDate |
2020-01-01 |
description |
Paragonimiasis, or Oriental lung fluke is a parasitic infestation seen in Asia, Africa and South America which is spread by the consumption of crabs and crayfish. To date four cases have been reported from Nepal. Here, we report a case of paragonimiasis in a young male from Kathmandu valley who presented with symptoms of fever, on and off for 1 month, shortness of breath and cough. He was found to have pleural effusion. Sputum examination did not reveal acid fast bacilli, However, based on clinical features, he was started on antitubercular treatment. There was initial improvement, but later, he continued to have cough and hemoptysis over the next 2 years and on subsequent High-Resolution Computerized Tomography (HRCT) he was found to have a cavitary lung lesion in the superior segment of lower lobe of left lung. A possibility of aspergillosis was considered for which he underwent a lobectomy. The gross examination of the lung showed a small cavity measuring 5 mm which revealed on histology a parasitic structure with serous glands within it. In addition, there were many foreign body granulomas with ova within them. A diagnosis of paragonimiasis was made and the patient was started on Praziquantal. He recovered well and is currently asymptomatic. We can learn from this case that the signs and symptoms of paragonimiasis mimic that of tuberculosis and the mistaken diagnosis can lead to unnecessary treatment, prolonged morbidity and loss of time and resources. |
topic |
Paragonimiasis Tuberculosis Nepal |
url |
http://www.sciencedirect.com/science/article/pii/S2213007120305128 |
work_keys_str_mv |
AT shreyashrivastav paragonimiasisamisseddiagnosisfromnepal AT anamikajha paragonimiasisamisseddiagnosisfromnepal |
_version_ |
1724380292521656320 |