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

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

Hydatid cyst is usually located in the liver and lungs, rare cases showing localization in other organs or tissues. In the unusual location, echinococcosis is an excluding diagnosis that is established only after microscopic evaluation. Our first case occurred in a 67-year-old female previously diagnosed with pulmonary tuberculosis and hospitalized with persistent pain in the hip joint. The clinical diagnosis was tuberculosis of the joint, but the presence of the specific acellular membrane indicated a hydatid cyst of the synovial membrane, without bone involvement. Fewer than 25 cases of joint hydatidosis have been reported in literature to date. In the second case, the intramural hydatid cyst was incidentally discovered at autopsy, in the left heart ventricle of a 52-year-old male hospitalized for a fatal brain hemorrhage, as a result of rupture of an anterior communicating artery aneurysm. The conclusion of our paper is that echinococcosis should be taken into account for the differential diagnosis of cystic lesions, independently from their location.
Aged ; Autopsy ; Diagnosis ; Diagnosis, Differential ; Echinococcosis* ; Echinococcus granulosus ; Female ; Heart Ventricles ; Heart* ; Hip Joint* ; Hip* ; Humans ; Intracranial Aneurysm ; Intracranial Hemorrhages ; Joints ; Liver ; Lung ; Male ; Membranes ; Middle Aged ; Myocardium ; Osteoarthritis, Hip ; Rupture ; Synovial Membrane ; Tuberculosis ; Tuberculosis, Pulmonary

Paragonimiasis is a parasitic disease caused by Paragnonimus species. The primary site of infection is the lung, and extrapulmonary involvement is also reported. When infected with Paragonimus westermani, which is the dominant species in Korea, the central nervous system is frequently involved along with the liver, intestine, peritoneal cavity, retroperitoneum, and abdominal wall. Ectopic paragonimiasis raises diagnostic challenge since it is uncommon and may be confused with malignancy or other inflammatory diseases. Here, we report an ectopic paragonimiasis case initially presented with recurrent abdominal pain. The patient developed abdominal pain 3 times for the previous 3 years and the computed tomography (CT) of the abdomen revealed fluid collection with wall enhancement. Recurrent diverticulitis was initially suspected and part of the ascending colon was resected. However, the specimen showed intact colon wall without evidence of diverticulitis and multiple parasite eggs and granulomas were found instead. The size of about 70 μm, the presence of an operculum and relatively thick egg shell suggested eggs of Paragonimus species. With appropriate exposure history and a positive antibody test, the definitive diagnosis was made as peritoneal paragonimiasis.
Abdomen ; Abdominal Abscess* ; Abdominal Pain ; Abdominal Wall ; Abscess ; Animals ; Central Nervous System ; Colon ; Colon, Ascending ; Diagnosis ; Diverticulitis* ; Egg Shell ; Eggs ; Granuloma ; Humans ; Intestines ; Korea ; Liver ; Lung ; Ovum ; Paragonimiasis* ; Paragonimus ; Paragonimus westermani ; Parasites ; Parasitic Diseases ; Peritoneal Cavity

Cystic echinococcosis (CE) caused by Echinococcus granulosus is a major public health problem worldwide, including Turkey. The aim of the current study was to identify the strains and to estimate the potential risk factors of E. granulosus in operated pediatric cases in eastern Turkey. Ten pediatric patients (7 boys and 3 girls) living in rural areas, with ages ranging from 3 to 15 years old and various clinical histories, were included in this study. Eight patients had only liver hydatid cyst, while 1 patient had liver and lung hydatid cyst and the other liver, lung, and spleen, together. There were 2 ruptured liver cysts. After surgery, during follow-up, no increase was observed in hemagglutination levels, there were no mortalities, and there was no evidence of recurrence at 2 years post operation in all patients. Molecular analysis was performed on hydatid cyst samples obtained from the 10 pediatric cases. According to mt-12S rRNA PCR results, all cases were found to be G1/G3 cluster of E. granulosus sensu stricto.
Adolescent ; Animals ; Child ; Child, Preschool ; Echinococcosis/parasitology/*surgery ; Echinococcosis, Hepatic/parasitology/surgery ; Echinococcosis, Pulmonary/parasitology/surgery ; Echinococcus granulosus/genetics/*isolation & purification ; Female ; Humans ; Male ; Turkey

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 ; Adult ; Aged ; Animals ; Biological Markers/analysis ; Child ; Child, Preschool ; Diagnosis, Differential ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia/diagnosis/parasitology ; Female ; Glucose/analysis ; Humans ; L-Lactate Dehydrogenase/analysis ; Lung Diseases, Parasitic/*diagnosis/metabolism/parasitology/radiography ; Male ; Middle Aged ; Paracentesis ; Paragonimiasis/*diagnosis/metabolism/parasitology/radiography ; Paragonimus westermani/*isolation & purification ; Pleural Effusion/*diagnosis/metabolism/parasitology/radiography ; Predictive Value of Tests ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis, Pleural/*diagnosis ; Young Adult

No abstract available.
Female ; Humans ; Lung Diseases, Parasitic/*parasitology ; Parabasalidea/*isolation & purification ; Protozoan Infections/*parasitology

Hydatid cyst, a common disease in the world, is usually transmitted to humans through dog feces. Hydatid cyst is caused by Echinococcus granulosus. Diagnostic interventions for hydatid cyst include physical examination and chest x-ray tomography. Although the treatment options of hydatid cyst vary according to the clinical findings of the patients, the primary treatment may be considered as surgery. We herein reported the case of a child hospitalized due to pneumonia who developed anaphylaxis as a result of the rupture of a pulmonary hydatid cyst.
Adolescent ; Anaphylaxis ; Animals ; Child ; Dogs ; Echinococcosis ; Echinococcosis, Pulmonary ; Echinococcus granulosus ; Eosinophils ; Feces ; Humans ; Male ; Physical Examination ; Pneumonia ; Rupture ; Thorax ; Tomography, X-Ray

A 45-year-old-male who had underlying ulcerative colitis and presented with fever and dry cough. Initially, the patient was considered to have invasive aspergillosis due to a positive galactomannan assay. He was treated with amphotericin B followed by voriconazole. Nevertheless, the patient deteriorated clinically and radiographically. The lung biopsy revealed eosinophilic pneumonia, and ELISA for Toxocara antigen was positive, leading to a diagnosis of pulmonary toxocariasis. After a 10-day treatment course with albendazole and adjunctive steroids, the patient recovered completely without any sequelae. Pulmonary toxocariasis may be considered in patients with subacute or chronic pneumonia unresponsive to antibiotic agents, particularly in cases with eosinophilia.
Albendazole/therapeutic use ; Animals ; Anthelmintics/therapeutic use ; Anti-Inflammatory Agents/therapeutic use ; Antigens, Helminth/analysis ; Colitis, Ulcerative/*complications ; Diagnosis, Differential ; Enzyme-Linked Immunosorbent Assay ; Humans ; Lung/pathology ; Lung Diseases, Parasitic/*diagnosis/*pathology ; Male ; Middle Aged ; Pulmonary Aspergillosis/diagnosis/pathology ; Steroids/therapeutic use ; Toxocara/*isolation & purification ; Toxocariasis/*diagnosis/*pathology ; Treatment Outcome

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