Yadav Aseem, Kumar Anshu, Agarwal Deeptika, Kumar Ajai
Medical Division, Military Hospital Namkum, Ranchi, India.
Department of Laboratory Sciences, Military Hospital Namkum, Ranchi, India.
Med J Armed Forces India. 2022 Sep;78(Suppl 1):S266-S268. doi: 10.1016/j.mjafi.2019.10.007. Epub 2020 Jan 9.
Paragonimiasis is a crustacean-borne parasitic zoonosis caused by lung fluke or Paragonimus. Several endemic foci of paragonimiasis have been discovered in Northeastern India. Chronic pulmonary infection with Paragonimus is characterized by hemoptysis, which is usually mistaken for Tuberculosis (TB). Paragonimiasis is acquired by eating raw, undercooked, or pickled crabs or crayfish containing encysted metacercariae of Paragonimus. Infection can usually be confirmed by finding Paragonimus eggs in sputum or bronchoalveolar lavage. We present a rare case of paragonimiasis masquerading as hypereosinophilia, asthma, and intracerebral hemorrhage for the last three years. Paragonimiasis is a rare cause of hemoptysis outside endemic regions. A strong index of suspicion is required to diagnose paragonimiasis outside the endemic areas. Diagnosis is usually delayed because of similarity of presentation to TB. Our patient was symptomatic with hemoptysis for three years. He gave history of eating raw crayfish and crabs while on leave to his native village in Nagaland. Diagnosis was confirmed on microscopy by detection of Paragonimus ova in sputum and bronchoalveolar lavage specimens. Symptoms resolved on treatment with praziquantel (25 mg/kg TDS for three days). Patient became symptom-free after a week of treatment.
肺吸虫病是一种由肺吸虫或并殖吸虫引起的经甲壳类动物传播的寄生虫人畜共患病。在印度东北部已发现多个肺吸虫病的流行病灶。肺吸虫的慢性肺部感染以咯血为特征，咯血通常被误诊为肺结核（TB）。食用含有肺吸虫囊蚴的生的、未煮熟的或腌制的螃蟹或小龙虾会感染肺吸虫病。通常通过在痰液或支气管肺泡灌洗中发现肺吸虫卵来确诊感染。我们报告了一例罕见的肺吸虫病病例，在过去三年中一直表现为嗜酸性粒细胞增多、哮喘和脑出血。在流行地区以外，肺吸虫病是咯血的罕见原因。在流行地区以外诊断肺吸虫病需要高度怀疑。由于临床表现与肺结核相似，诊断通常会延迟。我们的患者咯血症状已持续三年。他有在回那加兰邦的家乡休假时食用生小龙虾和螃蟹的病史。通过显微镜检查在痰液和支气管肺泡灌洗标本中检测到肺吸虫卵，确诊了该病。使用吡喹酮（25毫克/千克，每日三次，共三天）治疗后症状缓解。治疗一周后患者症状消失。
