Paragonimiasis: Neglected, Re-Emerging or Expanding Frontiers. Lessons from a Case Presenting in Jos, Plateau State.

Area of Science:

• Medical Parasitology
• Infectious Diseases
• Public Health

Background:

• Paragonimiasis is endemic in Eastern Nigeria, with a notable resurgence post-Nigeria/Biafra war due to increased consumption of raw freshwater crabs.
• The disease's varied symptoms often lead to misdiagnosis, confusing it with other conditions like tuberculosis.
• Interest in reporting this case is heightened by its presentation outside the typical endemic region.

Observation:

• A patient from Eastern Nigeria presented with symptoms suggestive of Paragonimiasis but was initially treated for tuberculosis.
• Despite negative sputum Acid-Fast Bacilli (AFB) tests, the patient did not improve with tuberculosis treatment.
• The patient later presented in Jos, where a thorough history led to the suspicion and confirmation of Paragonimiasis.

Findings:

• The confirmed case of Paragonimiasis occurred in a patient with severe cor-pulmonale.
• Despite treatment, the patient succumbed to the illness, indicating advanced disease progression.
• The case underscores the diagnostic challenges posed by Paragonimiasis's protean manifestations.

Implications:

• In Nigeria's current economic climate, a resurgence of Paragonimiasis is possible as people may turn to cheaper protein sources like raw crabs.
• Healthcare providers should maintain a high index of suspicion for Paragonimiasis in patients presenting with chronic cough, AFB-negative sputum, and hemoptysis.
• Prompt diagnosis and treatment are crucial to prevent severe complications such as cor-pulmonale and mortality associated with Paragonimiasis.