Case Report: Paragonimiasis Presenting with Pericardial Tamponade

Area of Science:

• Infectious Diseases
• Parasitology
• Cardiology

Background:

• Paragonimiasis is a parasitic infection typically caused by consuming raw or undercooked crustaceans like crabs and crayfish.
• The parasite, Paragonimus species, usually resides in the lungs but can migrate to other organs.
• Pericardial effusion and tamponade are serious conditions involving fluid accumulation around the heart, potentially leading to cardiac arrest.

Observation:

• An unusual case of paragonimiasis presented with massive pericardial effusion and cardiac tamponade in a Nepali patient.
• The patient denied consuming the usual sources of Paragonimus infection, such as crabs, crayfish, or wild animal meat.
• The suspected source of infection was the ingestion of raw, live slugs as part of a traditional medicine practice.

Findings:

• The case highlights an atypical presentation of paragonimiasis involving the pericardial space, leading to life-threatening cardiac complications.
• This suggests that Paragonimus species can cause extrapulmonary paragonimiasis through less common routes of transmission.
• The diagnosis was confirmed through relevant clinical and diagnostic findings, although specific diagnostic methods were not detailed in the abstract.

Implications:

• This case broadens the understanding of potential transmission routes for paragonimiasis, emphasizing the risk associated with consuming raw animal products, including slugs.
• It underscores the importance of considering parasitic infections in patients with unexplained pericardial effusion and tamponade, especially in endemic or relevant geographical regions.
• Clinicians should inquire about diverse dietary habits and traditional medicine practices when evaluating patients with suspected parasitic infections and cardiac conditions.