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Paragonimiasis ectópica que se presenta como derrame pericárdico masivo en un niño: un desafío diagnóstico raro
Xiaomei Wang1, Junbo Wu2, Juan Huang3
1Department of Laboratory Medicine, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430015, P. R. China.
Resumen
La paragonimiasis, una infección parasitaria, puede causar derrame pericárdico en niños. El diagnóstico temprano mediante imágenes y serología es crucial para prevenir la pericarditis constrictiva.
Área de la Ciencia:
- Enfermedades Infecciosas; Parasitología; Cardiología
Sus antecedentes:
- La paragonimiasis es una enfermedad parasitaria transmitida por alimentos.; Típicamente afecta los pulmones, pero raramente puede involucrar el pericardio.; La paragonimiasis ectópica presenta desafíos diagnósticos, especialmente en niños.
Objetivo del estudio:
- Informar un caso raro de paragonimiasis ectópica pediátrica que se presenta como derrame pericárdico aislado.; Destacar los desafíos diagnósticos y enfatizar las herramientas diagnósticas clave.; Subrayar la importancia del reconocimiento e intervención tempranos para prevenir complicaciones.
Principales métodos:
- Reporte de caso de un niño de 10 años de un área endémica de China.; Análisis de la presentación clínica, hallazgos de laboratorio (análisis del líquido pericárdico, eosinofilia periférica, óvulos en heces) e imágenes (ecocardiografía).; Tratamiento con praziquantel, corticosteroides y posterior pericardiectomía.
Principales resultados:
- El paciente presentó síntomas gastrointestinales agudos y derrame pericárdico masivo sin signos respiratorios.; El análisis del líquido pericárdico no fue concluyente; la eosinofilia periférica y los óvulos en heces estuvieron ausentes.; La ecocardiografía reveló un patrón "similar a un capullo"; la serología fue positiva para Paragonimus IgG.; Se confirmó inflamación granulomatosa necrosante post-pericardiectomía.
Conclusiones:
- La paragonimiasis ectópica que se presenta como derrame pericárdico aislado es un desafío diagnóstico.; La historia epidemiológica, las características ecocardiográficas y la serología son vitales para el diagnóstico.; La intervención oportuna es crucial para prevenir la pericarditis constrictiva en regiones endémicas.
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