Human pulmonary dirofilariasis has been documented from many parts of the world, but not in Korea so far. We experienced a patient of pulmonary dirofilariasis who had visited a local clinic because of chest pain for 1 month. On chest radiograph, a coin lesion of 2 cm diameter and enlargement of the mediastinal lymph node were shown. An exploratory lung resection was done. Pathologically the lesion was a pulmonary dirofilariasis complicated with necrotic pneumonia, fibrosis, and infarction. At the center of the lesion, degenerated nematode sections with multilayered cuticle, thick musculature, and bilateral internal ridges on each side were found, which was identified to be Dirofilaria immitis. This is the first report of human pulmonary dirofilariasis in Korea.
Case Report ; Dirofilariasis/pathology* ; Dirofilariasis/diagnosis ; Human ; Lung Diseases, Parasitic/pathology* ; Lung Diseases, Parasitic/diagnosis ; Male ; Middle Age

Bronchopneumonia ; diagnosis ; parasitology ; Female ; Humans ; Lung Diseases, Parasitic ; diagnosis ; parasitology ; Male ; Protozoan Infections ; diagnosis ; parasitology

Human infections with Lophomonas blattarum are rare. However, the majority of the infections occurred in China, 94.4% (136 cases) of all cases in the world. This infection is difficult to differentiate from other pulmonary infections with similar symptoms. Here we reported a case of L. blattarum infection confirmed by bronchoalveolar lavage fluid smear on the microscopic observations. The patient was a 21-year-old female college student. The previous case which occurred in Chongqing was 20 years ago. We briefly reviewed on this infection reported in the world during the recent 20 years. The epidemiological characteristics, possible diagnostic basis, and treatment of this disease is discussed in order to provide a better understanding of recognition, diagnosis, and treatment of L. blattarum infection.
Female ; Humans ; Lung Diseases, Parasitic/diagnosis/*parasitology ; Parabasalidea/*isolation & purification ; Protozoan Infections/*parasitology ; Young Adult

Abdominal Pain ; etiology ; Child ; Female ; Humans ; Lung Diseases, Parasitic ; complications ; diagnosis

Bronchopneumonia ; diagnosis ; parasitology ; Diagnosis, Differential ; Diagnostic Errors ; Humans ; Lung Diseases, Parasitic ; diagnosis ; parasitology ; Protozoan Infections ; diagnosis ; parasitology

Paragonimiasis typically results from the consumption of raw or improperly cooked crustacea, especially crabs and crayfish. Although previously endemic in Korea, the prevalence of this disease decreased in the early 1970s because of educational campaigns and fewer intermediate hosts as a result of ecological changes. Recently, we were presented with a family where all members were infected with Paragonimus after ingestion of Kejang (= drunken crab). The mother was hospitalized for general myalgia and weakness first, followed by the father, who was hospitalized for dyspnea 2 month later. After the parents were diagnosed with paragonimiasis, we recommended their daughter to visit our hospital for a checkup, because they all had eaten freshwater crabs soaked in soybean sauce. She complained of generalized myalgia, fever, and pleuritic pain, and was also diagnosed with paragonimiasis. Peripheral blood of the 3 patients revealed hypereosinophilia, and computed tomography (CT) scans of their chests showed pleural effusion. The results of antibody tests by ELISA were positive for paragonimiasis. We report here the case series of familial paragonimiasis in a modern urban city, rather than in a typical endemic area.
Adult ; Animals ; Family ; Female ; Humans ; Korea ; Lung Diseases, Parasitic/*diagnosis/radiography ; Male ; Middle Aged ; Paragonimiasis/*diagnosis/radiography ; Paragonimus/isolation & purification

OBJECTIVETo study the clinical manifestations and pathologic findings of paragonimiasis.

METHODSNine cases of paragonimiasis diagnosed in the Peking Union Medical College Hospital during the past 20 years were studied, with literature review and analysis of the epidemiological, clinical and pathologic characteristics.

RESULTSOf the 9 cases studied, 4 came from the northeast China and 5 from Beijing. Eight cases had a history of eating raw crabs. Most had symptoms including fever, chest discomfort or pain, and hemoptysis or rusty sputum. All had the following common pathologic features: formation of irregular lacunae or sinus tracts, Charcot-Leyden crystals, sometimes paragonimus body parts and/or eggs, and eosinophil infiltration in the adjacent tissues.

CONCLUSIONSParagonimiasis is not as uncommon as previously thought. The incidence is increasing in some cities due to movement of populations. The pathological diagnosis can be confirmed by finding paragonimus body parts and/or eggs. Diagnosis can also be made by correlation with other typical pathologic features, clinical history, immunologic findings and radiography. Paragonimiasis needs to be differentiated from pulmonary tuberculosis and cancer.

Adult ; Diagnosis, Differential ; Female ; Humans ; Lung Diseases, Parasitic ; diagnosis ; pathology ; Lung Neoplasms ; diagnosis ; Male ; Middle Aged ; Paragonimiasis ; diagnosis ; pathology ; Tuberculosis, Pulmonary ; diagnosis

Dirofilariasis is a rare disease in humans. We report here a case of a 48-year-old male who was diagnosed with pulmonary dirofilariasis in Korea. On chest radiographs, a coin lesion of 1 cm in diameter was shown. Although it looked like a benign inflammatory nodule, malignancy could not be excluded. So, the nodule was resected by video-assisted thoracic surgery. Pathologically, chronic granulomatous inflammation composed of coagulation necrosis with rim of fibrous tissues and granulations was seen. In the center of the necrotic nodules, a degenerating parasitic organism was found. The parasite had prominent internal cuticular ridges and thick cuticle, a well-developed muscle layer, an intestinal tube, and uterine tubules. The parasite was diagnosed as an immature female worm of Dirofilaria immitis. This is the second reported case of human pulmonary dirofilariasis in Korea.
Animals ; Diagnosis, Differential ; Dirofilaria immitis/*isolation & purification ; Dirofilariasis/*diagnosis/parasitology/surgery ; Humans ; Lung/pathology ; Lung Diseases, Parasitic/*diagnosis/parasitology/surgery ; Male ; Middle Aged ; Republic of Korea ; Treatment Outcome

Child, Preschool ; Diagnostic Errors ; Female ; Humans ; Lung Diseases, Parasitic ; diagnosis ; Pericardial Effusion ; diagnosis ; parasitology ; Pleural Effusion ; diagnosis ; parasitology ; Trematode Infections ; diagnosis

Reported here is a case of microsporidiasis that occurred in an acute myeloblastic leukemia (AML) -M3 patient who underwent chemotherapy. Fever, cough, expectorate and dyspnea were observed during the therapy. Since this case was considered as adult respiratory distress syndrome due to the chest X-ray and arterial blood gas findings, the male patient was bounded to a mechanical ventilator. As coagulation tests showed compatible findings with disseminate intravascular coagulation (DIC), it was thought to be a case of sepsis originating from the lungs and DIC. Pseudomonas aeruginosa and Staphylococcus aureus were found in the sputum of the patient. Although he was given combined antibiotic therapy, there was no reduction in the fever. A bronchoalveolar lavage (BAL) sample was taken and Microsporidia sp. was found upon staining with Giemsa. The patient died due to sepsis and DIC just before receiving therapy for microsporidiasis. Pulmonary infection with Microsporidia, although classically occurring in patients with HIV infection, may occur rarely in leukemia patients, especially if previously treated with systemic immune suppression. This case reinforces the need to consider Microsporidia as a possible pathogen in immunocompromised patients with pulmonary infections.
Diagnostic Errors ; Fatal Outcome ; Human ; Immunocompromised Host ; Leukemia, Myelocytic, Acute/*complications ; Lung Diseases, Parasitic/*complications/diagnosis ; Male ; Microsporidiosis/*complications/diagnosis ; Middle Aged