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Chronic Thromboembolic Pulmonary Hypertension and Assessment of Right Ventricular Function in the Piglet

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A curious case of hemoptysis.

Aseem Yadav¹, Anshu Kumar², Deeptika Agarwal¹

¹Medical Division, Military Hospital Namkum, Ranchi, India.

Medical Journal, Armed Forces India

|September 23, 2022

Summary

Paragonimiasis, a lung fluke infection, can mimic other diseases like Tuberculosis. Early diagnosis and praziquantel treatment are crucial for recovery from this rare parasitic zoonosis.

Keywords:

Endemic hemoptysis Hemoptysis Paragonimiasis Paragonimus Tuberculosis

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Area of Science:

Parasitology
Infectious Diseases
Public Health

Background:

Paragonimiasis is a parasitic zoonosis caused by lung flukes (Paragonimus), endemic in parts of Northeastern India.
Infection is acquired by consuming raw or undercooked crustaceans harboring Paragonimus metacercariae.
Chronic pulmonary paragonimiasis often presents with hemoptysis, frequently misdiagnosed as Tuberculosis (TB).

Observation:

A rare case of paragonimiasis presented atypically with hypereosinophilia, asthma, and intracerebral hemorrhage over three years.
The patient reported consuming raw crayfish and crabs from a known endemic region.
Diagnosis was confirmed by identifying Paragonimus eggs in sputum and bronchoalveolar lavage.

Findings:

Microscopic detection of Paragonimus ova in respiratory specimens confirmed the diagnosis.
Symptoms, including hemoptysis, resolved effectively after treatment with praziquantel.
The patient achieved a symptom-free state within a week of completing the prescribed treatment regimen.

Implications:

Paragonimiasis should be considered in the differential diagnosis of hemoptysis, especially in individuals with a history of consuming raw crustaceans.
A high index of suspicion is vital for diagnosing paragonimiasis outside endemic areas.
Prompt diagnosis and praziquantel treatment lead to complete recovery, highlighting the importance of awareness and diagnostic capabilities.