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Pediatric paragonimiasis: a retrospective analysis of cases from a county in south-west China
Yong-Xin Jiang1, Gong-Qiang Li1, Cheng-Jing Pan1
1Department of Pediatrics, Yanjin Country People's Hospital, Zhaotong, China.
Insights
Paragonimiasis in children presents with varied symptoms, often leading to misdiagnosis. Early recognition and treatment with praziquantel generally lead to good outcomes, though sequelae can occur.
Area of Science:
- Medical Parasitology
- Pediatric Infectious Diseases
- Diagnostic Imaging
Background:
- Paragonimiasis, a parasitic lung fluke infection, exhibits diverse and non-specific clinical signs in children, increasing the risk of misdiagnosis.
- Accurate diagnosis and effective management are crucial for preventing complications and long-term sequelae in pediatric cases.
Purpose of the Study:
- To analyze the clinical manifestations, laboratory findings, treatment responses, and outcomes of paragonimiasis in children.
- To enhance the recognition of pediatric paragonimiasis and reduce diagnostic errors.
Main Methods:
- Retrospective analysis of clinical data from 45 children diagnosed with paragonimiasis between August 2016 and July 2022.
- Inclusion of demographic, medical history, and laboratory data; review of imaging findings such as CT/MRI.
Main Results:
- Common clinical features included fever, cough, pleural effusion, peritoneal effusion, and subcutaneous nodules.
- Key imaging findings were alveolar exudation, effusions, pleural thickening, nodules, and the diagnostic 'tunnel sign' on CT/MRI.
- Praziquantel treatment resulted in improvement for most children; one case of cerebral paragonimiasis developed sequelae.
Conclusions:
- Pediatric paragonimiasis generally has a favorable prognosis with praziquantel treatment, but potential for sequelae exists.
- Preventive measures, including avoiding untreated water and raw food, are effective in controlling the spread of paragonimiasis.
Introduction:
The clinical manifestations of paragonimiasis are diverse and non-specific, and can easily lead to misdiagnosis. We aimed to analyze the clinical manifestations, laboratory features, treatment, and clinical outcome of children with paragonimiasis in order to improve recognition of this disease and avoid misdiagnosis.
Methods:
Children diagnosed with paragonimiasis from August 2016 to July 2022 were included in the study. Information on population informatics, medical history, and laboratory features was extracted from case data. The clinical features of paragonimiasis were retrospectively analyzed.
Results:
A total of 45 children were included in this study. All children had, at least, one risk factor. The clinical features mainly included fever, cough, pleural effusion, peritoneal effusion, and subcutaneous nodules. The main imaging findings were alveolar exudation, peritoneal effusion, pleural thickening, and local nodules. The "tunnel sign" finding on computed tomography (CT)/magnetic resonance imaging (MRI) was helpful in establishing the diagnosis of paragonimiasis. After praziquantel treatment, most of the children improved, and one child with cerebral paragonimiasis experienced sequelae.
Conclusion:
Most children with paragonimiasis have a good prognosis, but few children can experience sequelae. Avoidance of untreated water and raw food is a simple, feasible, and effective preventive measure.
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