Singh T S, Mutum S S, Razaque M A
Trans R Soc Trop Med Hyg. 1986;80(6):967-71. doi: 10.1016/0035-9203(86)90275-0.
Thirty-nine cases of pulmonary paragonimiasis due to Paragonimus westermani were identified in Manipur, India. Recurrent haemoptysis, often increased on exertion, was the most common symptom. The clinical features and radiological appearances simulated pulmonary tuberculosis and 23 cases were treated for tuberculosis for varying periods before the final diagnosis. Young males aged 11 to 30 years comprised two-thirds of the cases. The disease was acquired by eating raw or improperly cooked crabs (Potamon deham). Intradermal tests (IDT) employing a saline extract of adult Paragonimus were a simple and reliable method of detecting present or past infection. Erythema of large size even without wheal and pseudopodia may indicate a positive IDT. Charcot-Leyden crystals (CLC) were detected in all sputum samples positive for Paragonimus ova. In patients (four) presenting with pleural effusion, Paragonimus ova were not present in the sputum, stool or pleural fluid. Bithionol (2,2'-thiobis [4,6-dichlorophenol]) orally, 40 mg/kg body-weight/day, 10 to 25 doses, cured all cases and, except in one, side effects were minimal. Relapse in one patient after six months' treatment was apparently cured by a second course of Bithionol.
在印度曼尼普尔邦，确认了39例由卫氏并殖吸虫引起的肺吸虫病。反复咯血，常在用力时加重，是最常见的症状。临床特征和影像学表现类似肺结核，23例在最终确诊前曾接受过不同疗程的抗结核治疗。11至30岁的年轻男性占病例的三分之二。该病通过食用生的或未煮熟的螃蟹（德汉溪蟹）感染。采用成虫盐水提取物进行皮内试验（IDT）是检测现症或既往感染的一种简单可靠的方法。即使没有风团和伪足，大面积红斑也可能提示IDT阳性。在所有肺吸虫虫卵阳性的痰标本中均检测到夏科-莱登晶体（CLC）。4例出现胸腔积液的患者，痰液、粪便或胸腔积液中均未发现肺吸虫虫卵。口服硫双二氯酚（2,2'-硫代双[4,6-二氯苯酚]），40mg/kg体重/天，10至25剂，治愈了所有病例，除1例患者外，副作用极小。1例患者在治疗6个月后复发，再次使用硫双二氯酚疗程后明显治愈。
