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[A Retrospective Analysis on 47 Children with Paragonimiasis in Ningbo City]
Insights
Paragonimiasis in children is often diagnosed via serum antibody tests, as eggs are rarely found in sputum or stool. Praziquantel treatment showed no adverse effects in this pediatric study.
Area of Science:
- Medical Parasitology
- Pediatric Infectious Diseases
- Clinical Diagnostics
Background:
- Paragonimiasis, a parasitic lung fluke infection, poses diagnostic challenges, especially in pediatric populations.
- Traditional diagnostic methods like egg detection in sputum and stool are often insensitive in children.
- Understanding the clinical presentation and diagnostic utility of serological tests in pediatric paragonimiasis is crucial.
Purpose of the Study:
- To analyze the clinical characteristics and diagnostic findings of paragonimiasis in children.
- To evaluate the effectiveness of serological diagnostic methods in pediatric cases.
- To assess the safety and efficacy of praziquantel treatment in children with paragonimiasis.
Main Methods:
- Retrospective analysis of 47 pediatric paragonimiasis cases diagnosed between 2004 and 2014.
- Review of patient demographics, clinical symptoms, exposure history, laboratory findings (eosinophil count, IgE levels), and diagnostic test results.
- Evaluation of treatment outcomes following praziquantel administration.
Main Results:
- Most cases (68.1%) occurred in boys, with a slight urban-rural distribution.
- A trend of increased incidence in preschoolers was observed since 2010.
- Consumption of raw or wine-preserved crabs was the primary exposure route (43 cases).
- Neurological complications (encephalopathy) and subcutaneous nodules were observed in a minority of cases.
- Elevated eosinophil counts (39 cases) and serum IgE levels (29 cases) were common.
- Paragonimus eggs were not detected in sputum or stool in any of the 47 cases.
- Dot immuno-gold filtration assay and ELISA demonstrated a 100% positive rate for serum antibodies.
- Praziquantel treatment was well-tolerated with no reported adverse effects.
Conclusions:
- Serological tests, including dot immuno-gold filtration assay and ELISA, are highly sensitive for diagnosing pediatric paragonimiasis when egg detection is negative.
- Praziquantel is a safe and effective treatment for pediatric paragonimiasis.
- Increased surveillance and awareness are needed, particularly for preschool-aged children, given the observed trend.
Abstract:
A retrospective analysis was performed on 47 children diagnosed with paragonimiasis in Ningbo Women and Children’s Hospital from January 2004 to December 2014. The 47 children comprised 32 boys （68.1%） and 15 girls （48.9%）, and 24 cases（51.1%） in urban areas and 23 （48.9%） in rural areas （P>0.05）. There was a trend of increase in paragonimiasis occurrence in preschoolers since 2010. Forty-three cases had a history of eating raw or wine-preserved crabs and 4 cases had a history of drinking raw stream water． There were 2 cases of paragonimus encephalopathy and one case accompanied by subcutaneous nodules. Thirty-nine cases showed increases in eosinophil number and proportion in peripheral blood, and 29 cases showed increased serum IgE level. Forty-seven cases had negative results for detection of paragonimus eggs in sputum and stool. The dot immuno-gold filtration-assay and ELISA showed a 100% positive rate for paragonimus serum antibody. All the 47 cases were administered with praziquantel after diagnosis, and no adverse effect was reported during the treatment.
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