The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, 651010, Yunnan, China.
Oncology Department, People's hospital of Xishuangbanna Dai Autonomous Prefecture, Xishuangbanna, Jinghong, Yunnan, China.
J Cardiothorac Surg. 2021 Mar 19;16(1):28. doi: 10.1186/s13019-021-01408-y.
To summarize the clinical characteristics of adult cases of paragonimiasis with lung masses as the main manifestation in Xishuangbanna, Yunnan Province, analyze the causes of misdiagnosis, and improve the levels of clinical diagnosis and treatment.
We conducted a retrospective analysis of the clinical data and diagnosis and treatment of 8 adult cases of paragonimiasis with lung masses as the main manifestation that were diagnosed in the Oncology Department of People's hospital of Xishuangbanna Dai Autonomous Prefecture from July 2014 to July 2019.
All 8 patients were from epidemic paragonimiasis areas and had a confirmed history of consuming uncooked freshwater crabs. The clinical manifestations were mainly fever, dry cough, and chest pain. The disease durations were long, and peripheral blood eosinophil counts were elevated. The cases had been misdiagnosed as pneumonia or pulmonary tuberculosis. After years of anti-inflammatory or anti-tuberculosis treatment, the symptoms had not improved significantly. Patients eventually sought treatment from the oncology department for hemoptysis. Chest computed tomography showed patchy consolidation in the lungs, with nodules, lung masses, and enlarged mediastinal lymph nodes.
Paragonimiasis is a food-borne parasitic disease. Early clinical manifestations and auxiliary examination results are nonspecific. The parasite most often invades the lungs, and the resulting disease is often misdiagnosed as pneumonia, pulmonary tuberculosis, or lung cancer (Acta Trop 199: 05074, 2019). To avoid misdiagnosis, clinicians should inquire, in detail, about residence history and history of unclean food and exposure to infected water and make an early diagnosis based on the inquired information and imaging examination results. For patients who have been diagnosed with pneumonia or pulmonary tuberculosis and whose symptoms do not improve significantly after anti-inflammatory or anti-tuberculosis treatments, their epidemiological history should be traced to further conduct differential diagnosis and avoid misdiagnosis.
总结云南省西双版纳州以肺部肿块为主要表现的成人并殖吸虫病的临床特点，分析误诊原因，提高临床诊治水平。
回顾性分析 2014 年 7 月至 2019 年 7 月在西双版纳州人民医院肿瘤科诊断的 8 例以肺部肿块为主要表现的成人并殖吸虫病的临床资料及诊治情况。
8 例患者均来自并殖吸虫病流行区，有明确生食淡水蟹史，临床表现主要为发热、干咳、胸痛，病程长，外周血嗜酸性粒细胞计数升高，均误诊为肺炎或肺结核，经多年抗炎或抗结核治疗，症状无明显改善，因咯血就诊于肿瘤科，胸部 CT 表现为肺部斑片状实变影，伴有结节、肿块及纵隔淋巴结肿大。
并殖吸虫病是一种食源性寄生虫病，早期临床表现和辅助检查结果不具特异性，寄生虫多侵犯肺部，导致的疾病常被误诊为肺炎、肺结核或肺癌（Acta Trop 199：05074，2019）。为避免误诊，临床医生应详细询问居住史、不洁食物史和接触受感染水的情况，并根据询问信息和影像学检查结果做出早期诊断。对于诊断为肺炎或肺结核且抗炎或抗结核治疗后症状无明显改善的患者，应追查其流行病学史，进一步进行鉴别诊断，避免误诊。
