[Paragonimiasis in Cameroon: clinicoradiologic features and treatment outcome]

A prospective study of paragonimiasis was undertaken from September 1992 to July 1997 in the Mount Kupe zone of the Southwest Province of Cameroon. In a group of 2700 subjects, 312 presenting one or more signs of paragonimiasis underwent testing to detect Paragonimus africanus eggs in sputum and stools. Eggs were found in 30 subjects (9.61%). These patients underwent chest x-rays to assess radiological lesions due to paragonimiasis before and after treatment with Praziquantel. Symptoms included cough in all patients, hemoptysis in 13 (43.33%) and chest pain in 18 (60%). Only one patients presented altered general status. No patients presented fever. Before treatment chest x-rays demonstrated perinodular shadow in 22 patients (73.33%), pulmonary infiltrative opacity in 12 (40.00%), pulmonary nodules and cavitation in 3 (10.00%), pleuropulmonary calcification in 3 (10.00%), and cicatricial lesions in 2 (6.66%). Radiological findings were normal in 8 patients (26.66%). Following treatment parasitological and clinical cure was achieved at 1 and 2 months in all cases but X-ray abnormalities persisted for six months in 56.6% of cases. The most notable changes included disappearance of perihilar shadow in 8 out of 22 patients (36.36%) and worsening of radiological findings in 3 (13.66%). In 19 patients, treatment had no effect on X-ray findings in comparison with baseline. Absence of pleural effusion and high incidence of perihilar shadow may be specific features of paragonimiasis in Central Africa where the incidence of concomitant parasitic, fungal and microbial diseases is high.