ABSTRACT
Paragonimiasis in Yongjia County, Zhejiang Province, China, has been of such public health concern that a specialized Institute for Paragonimiasis Control has been established there. The study reported here involved both parasitological research on Paragonimus westermani in the endemic areas and a clinical analysis of 94 cases of paragonimiasis. Eggs were found in sputum, feces and brain tissue in 45 cases. Twenty patients, 19 of whom where children under 10 years of age, showed hepatic injury. Treatment with praziquantel or bithionol had satisfactory results in all cases. Dimensions of the parasite eggs, metacercariae from freshwater crabs and adult flukes suggested that the form of P. westermani in Yongjia is the 'small type': a suggestion supported by karyotypic studies on gonad cells from adult flukes collected from experimentally infected animals as all were found to be diploid. In conclusion, the 'small type' or diploid form of P. westermani is the cause of paragonimiasis pulmonary symptoms in Yongjia.
Subject(s)
Adolescent , Adult , Animals , Antiplatyhelmintic Agents/therapeutic use , Bithionol/therapeutic use , Carnivora , Cats , Child , China/epidemiology , Dogs , Endemic Diseases , Enzyme-Linked Immunosorbent Assay , Female , Humans , Karyotyping , Male , Microscopy, Electron, Scanning , Middle Aged , Paragonimiasis/drug therapy , Paragonimus/genetics , Parasite Egg CountABSTRACT
La presente revisión tiene como objetivo identificar las características clínicas, epidemiológicas y la evolución de cuatro niños con Fasciola hepática con manifestaciones poco usuales, evaluados en el Servicio de Gastroenterología Pediátrica del Instituto de Salud del Niño, Lima-Perú, entre 1988 y 1992. El primer paciente fue una niña de 9 años de edad que tenía fiebre, edema de miembros inferiores, circulación colateral y hepatomegalia predominantemente del lóbulo derecho. El diagnóstico inicial fue un neoplasma hepático. El segundo caso fue un niño de 6 años de edad que tuvo hemorragia gastrointestinal alta y fiebre; el diagnóstico endoscópico demonstró hemobilia. El tercer caso fue un niño de 12 año de edad que presentó edema generalizado y fue diagnosticado como sindrome nefrótico pero este diagnóstico fue descartado. El cuarto paciente fue un niño de 9 años de edad que presentó ictericia, fiebre y hemorragia gastrointestinal alta. Se verificaron cirrosis y várices esofágicas. En los cuatro pacientes el diagnóstico se realizó mediante la identificación de los huevos del parásito en heces. Los tres primeros casos respondieron satisfactoriamente al tratamiento con bithionol, el cuarto paciente falleció debido a falla sistémica.
Subject(s)
Child , Humans , Female , Antiplatyhelmintic Agents/therapeutic use , Bithionol/therapeutic use , Fasciola hepatica/isolation & purification , Fascioliasis/diagnosis , Metronidazole/therapeutic use , Feces/parasitology , Retrospective StudiesABSTRACT
Dentro del estudio clínico-terapéutico para determinar la posología efectiva de triclabendazole contra Paragonimus recibieron tratamiento con esta droga tres pacientes ecuatorianos con paragonimiasis pulmonar que fracasaron al tratamiento con emetina más cloroquina, bithienol y praziquantel individualmente. En todos los síntomas de tos, expectoración herrumbrosa y la presencia de huevos de Paragonimus mexicanus en esputo estaban presentes antes del tratamiento. Dos pacientes recibieron tricabendazole a 10mg/kg en dosis única, y el tercero a 5mg/kg una vez al día por tres días . El seguimiento hasta el año 1 postratamiento demostró la desaparición de la sintomatología y cura parasitológica. Los pacientes no presentaron efectos secundarios al fármaco.
Subject(s)
Humans , Female , Adolescent , Adult , Benzimidazoles/administration & dosage , Bithionol/therapeutic use , Emetine/therapeutic use , Lung Diseases, Parasitic/drug therapy , Paragonimiasis/drug therapy , Praziquantel/therapeutic use , EcuadorABSTRACT
Studies relating to the treatment of human taeniasis in the Philippines using Atabrine, bithionol, and mebendazole are reviewed. Cure rates of 93.7% for Atabrine, 85%-100% for bithionol, and 84.62% for mebendazole are reported. Aside from these studies, recent experience in the treatment of Taenia saginata infections at the Department of Parasitology, College of Public Health, is also reported. Twenty patients referred to the department were treated, 3 with bithionol, 17 with praziquantel. Of the 17 patients treated with praziquantel, the study reported cure rates of 47-88.24%.
Subject(s)
Bithionol/therapeutic use , Humans , Mebendazole/therapeutic use , Philippines , Praziquantel/therapeutic use , Quinacrine/therapeutic use , Taeniasis/drug therapyABSTRACT
A 2-year-old Manipuri girl had haemoptysis and a chest roentgenogram disclosed diffuse-infiltrates in the right lung. Microscopic examination of sputum and morning gastric aspirate showed numerous golden-brown, operculated ova, and microscopic examination of stool specimens confirmed these ova to be those of the lung fluke, Paragonimus westermani. She responded favourably to bithionol therapy and was asymptomatic and growing normally during follow up for one and half years.
Subject(s)
Bithionol/therapeutic use , Child, Preschool , Female , Hemoptysis/etiology , Humans , Lung Diseases, Parasitic/diagnosis , Paragonimiasis/diagnosis , Pneumonia/etiology , RecurrenceABSTRACT
A case of pulmonary paragonmiasis was diagnosed in a woman of the Manobo tribe in Marilog, Calinan, in the Davao region of Mindanao, the second-largest island in the Phillippine Archipelago. She had the first case of this disease reported in Mindanao. The patient was initially mis-diagnosed as having pulmonary tuberculosis, but failure of the standard triad regimen led to microscopic identification of Paragonimus westermani eggs in sputum. Therapy with Bithionol was successful in this case. One additional case was confirmed, and several more suspected, among members of this population group. From an epidemiologic standpoint, careful examination of chest x-rays will allow early differentiation between pulmonary paragonimiasis and tuberculosis, in areas where both conditions are endemic.