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Paragonimiasis miyazakii associated with bilateral pseudochylothorax
Y Inoue1, T Kawaguchi, A Yoshida
1Department of Internal Medicine, National Kinki-Chuo Hospital for Chest Diseases, Sakai, Osaka.
Internal Medicine (Tokyo, Japan)
|July 11, 2000
Summary
A man with high immunoglobulin E and eosinophilia was diagnosed with paragonimiasis after eating raw crabs. Early suspicion of this parasitic infection is key for effective praziquantel treatment.
Area of Science:
- Medical Parasitology
- Infectious Diseases
- Pulmonology
Background:
- Paragonimiasis is a parasitic lung infection caused by Paragonimus trematodes.
- Consumption of raw or undercooked freshwater crustaceans is a common transmission route.
- Clinical manifestations can be diverse, often mimicking other conditions.
Observation:
- A 37-year-old male presented with bilateral pleural effusions, subcutaneous abdominal induration, and marked blood eosinophilia.
- The patient reported recent consumption of raw crabs.
- Pleural fluid analysis revealed a pseudochylothorax with cholesterol crystals.
Findings:
- High levels of immunoglobulin E (36,580 IU/ml) and positive anti-Paragonimus miyazakii antibodies were detected.
- The patient showed a favorable response to praziquantel treatment.
- Diagnostic indicators included eosinophilia, pseudochylothorax, and elevated immunoglobulin E.
Implications:
- This case highlights the importance of considering paragonimiasis in patients with unexplained eosinophilia and pleural effusions.
- Prompt diagnosis and treatment with praziquantel can lead to successful outcomes.
- Clinicians should inquire about dietary history, particularly raw crustacean consumption, in relevant cases.