1.Infection Status of Freshwater Crabs and Crayfish with Metacercariae of Paragonimus westermani in Korea.
Eun Min KIM ; Jae Lip KIM ; Sung Il CHOI ; Soon Hyung LEE ; Sung Tae HONG
The Korean Journal of Parasitology 2009;47(4):425-426
The present study investigated the infection status of Paragonimus westermani metacercariae in freshwater crabs (n = 363) and crayfish (n = 31) from October 2007 to October 2008 using the crush method. All of the freshwater crabs, Eriocheir japonicus, were negative for P. westermani metacercariae while 10 (32.3%) of the 31 examined crayfish were positive. The 10 positive crayfish were caught in Haenam, Jeollanam-do, and there were 8-59 (mean 28.4) metacrcariae per infected crayfish. These results suggest that P. westermani metacerariae are still transmitted by crayfish enzootically in southern Korea, and that freshwater crabs may transmit metacercariae only on rare occasions.
Animals
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Astacoidea/*parasitology
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Brachyura/*parasitology
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Humans
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Korea/epidemiology
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Paragonimiasis/epidemiology/parasitology/*veterinary
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Paragonimus westermani/*isolation & purification
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Prevalence
3.A 27 kDa Cysteine Protease Secreted by Newly Excysted Paragonimus westermani Metacercariae Induces Superoxide Anion Production and Degranulation of Human Eosinophils.
Young Bae CHUNG ; Hirohito KITA ; Myeong Heon SHIN
The Korean Journal of Parasitology 2008;46(2):95-99
Eosinophil degranulation plays a crucial role in tissue inflammatory reactions associated with helminth parasitic nfections and allergic diseases. Paragonimus westermani, a lung fluke causing human paragonimiasis, secretes a large amount of cysteine proteases, which are involved in nutrient uptake, tissue invasion, and modulation of hos's immune responses. There is, however, limited information about the response of eosinophils to direct stimulation by cysteine proteases (CP) secreted by P. westermani. In the present study, we tested whether degranulation and superoxide production from human eosinophils can be induced by stimulation of the 2 CP (27 kDa and 28 kDa) purified from excretory-secretory products (ESP) of P. westermani newly excysted metacercariae (PwNEM). A large quantity of eosinophil-derived neurotoxin (EDN) was detected in the culture supernatant when human eosinophils isolated from the peripheral blood were incubated with the purified 27 kDa CP. Furthermore, the 27 kDa CP induced superoxide anion production by eosinophils in time- and dose-dependent manners. In contrast, the purified 28 kDa CP did not induce superoxide production and degranulation. These findings suggest that the 27 kDa CP secreted by PwNEM induces superoxide production and degranulation of human eosinophils, which may be involved in eosinophil-mediated tissue inflammatory responses during the larval migration in human paragonimiasis.
Animals
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Astacoidea/parasitology
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*Cell Degranulation
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Cysteine Endopeptidases/*immunology/isolation & purification
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Eosinophils/*immunology/metabolism
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Helminth Proteins/*immunology/isolation & purification
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Humans
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Paragonimiasis/*immunology/metabolism
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Paragonimus westermani/*enzymology/isolation & purification
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Superoxides/*immunology
4.A Pulmonary Paragonimiasis Case Mimicking Metastatic Pulmonary Tumor.
Ki Uk KIM ; Kwangha LEE ; Hye Kyung PARK ; Yeon Joo JEONG ; Hak Sun YU ; Min Ki LEE
The Korean Journal of Parasitology 2011;49(1):69-72
Pulmonary paragonimiasis is a relatively rare cause of lung disease revealing a wide variety of radiologic findings, such as air-space consolidation, nodules, and cysts. We describe here a case of pulmonary paragonimiasis in a 27-year-old woman who presented with a 2-month history of cough and sputum. Based on chest computed tomography (CT) scans and fluorodeoxyglucose positron emission tomography (FDG-PET) findings, the patient was suspected to have a metastatic lung tumor. However, she was diagnosed as having Paragonimus westermani infection by an immunoserological examination using ELISA. Follow-up chest X-ray and CT scans after chemotherapy with praziquantel showed an obvious improvement. There have been several reported cases of pulmonary paragonimiasis mimicking lung tumors on FDG-PET. However, all of them were suspected as primary lung tumors. To our knowledge, this patient represents the first case of paragonimiasis mimicking metastatic lung disease on FDG-PET CT imaging.
Adult
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Animals
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Diagnostic Errors
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Female
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Humans
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Lung Diseases, Parasitic/*diagnosis/*parasitology/radiography/radionuclide imaging
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Lung Neoplasms/*diagnosis
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Paragonimiasis/*diagnosis/*parasitology/radiography/radionuclide imaging
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Paragonimus westermani/isolation & purification
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Positron-Emission Tomography
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Tomography, X-Ray Computed
5.Seroprevalence of Tissue Invading Parasitic Infections Diagnosed by ELISA in Korea.
Mi Kyung LEE ; Sung Jong HONG ; Hye Ryoun KIM
Journal of Korean Medical Science 2010;25(9):1272-1276
Seroprevalence of the IgG antibodies for Clonorchis sinensis, Paragonimus westermani, Taenia solium metacestode (cysticercus), and Spirometra erinacei plerocercoid (sparganum) was measured using enzyme-linked immunosorbent assay (ELISA) in sera of patients in Korea from 1993 to 2006. A total of 74,448 specimens referred nationwide from 121 hospitals revealed an IgG positive rate of 7.6% for the 4 parasites. The IgG positive rate (18.7%) for the 4 parasites in 1993 decreased gradually to 6.6% in 2006. Individual positive rate decreased from 5.2% (1993) to 1.6% (2006) for C. sinensis, from 2.8% (1993) to 1.1% (2006) for P. westermani, from 8.3% (1993) to 2.2% (2006) for cysticercus, and from 2.6% (1993) to 1.6% (2006) for sparganum. The positive rate was highest (21.2%) in the group of patients who ranged in age from 50-59 yr old, and in the group that was referred from the Seoul area (55.9%). In conclusion, our results suggest that tissue invading parasitic infections should always be included in differential diagnosis for patients with eosinophilia associated lesions of the central nervous system, liver, and lungs in Korea.
Adolescent
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Adult
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Age Factors
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Aged
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Aged, 80 and over
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Animals
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Antibodies, Helminth/*blood
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Child
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Child, Preschool
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Clonorchiasis/diagnosis/*epidemiology
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Clonorchis sinensis/immunology/isolation & purification
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Cysticercosis/diagnosis/*epidemiology
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Cysticercus/immunology/isolation & purification
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Diagnosis, Differential
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Enzyme-Linked Immunosorbent Assay
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Eosinophilia/immunology
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Female
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Humans
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Immunoglobulin G/blood
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Infant
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Male
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Middle Aged
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Paragonimiasis/diagnosis/*epidemiology
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Paragonimus westermani/immunology/isolation & purification
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Republic of Korea/epidemiology
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Seroepidemiologic Studies
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Sparganosis/diagnosis/*epidemiology
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Sparganum/immunology/isolation & purification
6.Serial CT Findings of Paragonimus Infested Dogs and the Micro-CT Findings of the Worm Cysts.
Chang Hyun LEE ; Jung Gi IM ; Jin Mo GOO ; Hyun Ju LEE ; Sung Tae HONG ; Cheng Hua SHEN ; Doo Hyun CHUNG ; Kyu Ri SON ; Jung Min CHANG ; Hong EO
Korean Journal of Radiology 2007;8(5):372-381
OBJECTIVE: To investigate the serial CT findings of Paragonimus westermani infected dogs and the microscopic structures of the worm cysts using Micro-CT. MATERIALS AND METHODS: This study was approved by the committee on animal research at our institution. Fifteen dogs infected with P. westermani underwent serial contrast-enhanced CT scans at pre-infection, after 10 days of infection, and monthly thereafter until six months for determining the radiologic-pathologic correlation. Three dogs (one dog each time) were sacrificed at 1, 3 and 6 months, respectively. After fixation of the lungs, both multi-detector CT and Micro-CT were performed for examining the worm cysts. RESULTS: The initial findings were pleural effusion and/or subpleural ground-glass opacities or linear opacities at day 10. At day 30, subpleural and peribronchial nodules appeared with hydropneumothorax and abdominal or chest wall air bubbles. Cavitary change and bronchial dilatation began to be seen on CT scan at day 30 and this was mostly seen together with mediastinal lymphadenopathy at day 60. Thereafter, subpleural ground-glass opacities and nodules with or without cavitary changes were persistently observed until day 180. After cavitary change of the nodules, the migratory features of the subpleural or peribronchial nodules were seen on all the serial CT scans. Micro-CT showed that the cyst wall contained dilated interconnected tubular structures, which had communications with the cavity and the adjacent distal bronchus. CONCLUSION: The CT findings of paragonimiasis depend on the migratory stage of the worms. The worm cyst can have numerous interconnected tubular channels within its own wall and these channels have connections with the cavity and the adjacent distal bronchus.
Animals
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Contrast Media/administration & dosage
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Cysts/*parasitology/*radiography
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Disease Progression
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Dogs
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Female
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Follow-Up Studies
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Hydropneumothorax/parasitology
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Iohexol/analogs & derivatives/diagnostic use
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Lung/parasitology/radiography
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Male
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Observer Variation
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Paragonimiasis/*diagnosis/parasitology
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Paragonimus westermani/growth & development/isolation & purification
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Pleural Effusion/parasitology
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Radiographic Image Enhancement/methods
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Time Factors
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Tomography, X-Ray Computed/*methods
7.Pleural fluid characteristics of pleuropulmonary paragonimiasis masquerading as pleural tuberculosis.
Ki Eun HWANG ; Hyo Yeop SONG ; Jae Wan JUNG ; Su Jin OH ; Kwon Ha YOON ; Do Sim PARK ; Eun Taik JEONG ; Hak Ryul KIM
The Korean Journal of Internal Medicine 2015;30(1):56-61
BACKGROUND/AIMS: Pleuropulmonary paragonimiasis produces no specific symptoms or radiologic findings, allowing for the possibility of misdiagnosis. We evaluated the specific clinical and pleural fluid features of pleuropulmonary paragonimiasis masquerading as pleural tuberculosis. METHODS: We retrospectively analyzed the clinical and radiologic characteristics of 20 patients diagnosed with pleuropulmonary paragonimiasis between 2001 and 2011. RESULTS: In total, 17 patients presented with respiratory symptoms, including dyspnea (30%), hemoptysis (20%), cough (20%), and pleuritic chest pain (15%). Chest radiographs revealed intrapulmonary parenchymal lesions, including air-space consolidation (30%), nodular opacities (20%), cystic lesions (15%), ground-glass opacities (10%), and pneumothorax (5%). A pleural f luid examination revealed eosinophilia, low glucose levels, and high lactate dehydrogenase (LDH) levels in 87%, 76%, and 88% of the patients, respectively. These traits helped to distinguish pleuropulmonary paragonimiasis from other pleural diseases such as parapneumonic effusion, malignancy, and pleural tuberculosis. CONCLUSIONS: Pleuropulmonary paragonimiasis is often initially misdiagnosed as other pleural diseases. Therefore, it is important to establish the correct diagnosis. In patients with unexplained pleural effusion living in paragonimiasis-endemic areas, pleural fluid obtained by thoracentesis should be examined to distinguish pleuropulmonary paragonimiasis. When marked eosinophilia, high LDH levels, and low glucose levels are identified in pleural fluid, physicians could consider a diagnosis of pleuropulmonary paragonimiasis.
Adolescent
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Adult
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Aged
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Animals
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Biological Markers/analysis
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Child
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Child, Preschool
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Diagnosis, Differential
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Enzyme-Linked Immunosorbent Assay
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Eosinophilia/diagnosis/parasitology
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Female
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Glucose/analysis
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Humans
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L-Lactate Dehydrogenase/analysis
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Lung Diseases, Parasitic/*diagnosis/metabolism/parasitology/radiography
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Male
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Middle Aged
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Paracentesis
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Paragonimiasis/*diagnosis/metabolism/parasitology/radiography
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Paragonimus westermani/*isolation & purification
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Pleural Effusion/*diagnosis/metabolism/parasitology/radiography
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Predictive Value of Tests
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Retrospective Studies
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Tomography, X-Ray Computed
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Tuberculosis, Pleural/*diagnosis
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Young Adult