Paragonimus & paragonimiasis in India.

Ever since the discovery of the first indigenous case in 1981, paragonimiasis has gained recognition as a significant food borne parasitic zoonosis in India. The data available on the occurrence of paragonimiasis, until today, may be just the tip of an iceberg as the study areas covered were restricted to Northeast Indian States. Nevertheless, the results of research on paragonimiasis in India have revealed valuable information in epidemiology, life cycle, pathobiology and speciation of Indian Paragonimus. Potamiscus manipurensis, Alcomon superciliosum and Maydelliathelphusa lugubris were identified as the crab hosts of Paragonimus. Paragonimus miyazakii manipurinus n. sub sp., P. hueit’ungensis, P. skrjabini, P. heterotremus, P. compactus, and P. westermani have been described from India. P. heterotremus was found as the causative agent of human paragonimiasis. Ingestion of undercooked crabs and raw crab extract was the major mode of infection. Pulmonary paragonimiasis was the commonest clinical manifestation while pleural effusion and subcutaneous nodules were the common extra-pulmonary forms. Clinico-radiological features of pulmonary paragonimiasis simulated pulmonary tuberculosis. Intradermal test, ELISA and Dot-immunogold filtration assay (DIGFA) were used for diagnosis and epidemiological survey of paragonimiasis. Phylogenitically, Indian Paragonimus species, although nested within the respective clade were distantly related to others within the clade.

Paragonimiasis in the Abdominal Cavity and Subcutaneous Tissue: Report of 3 Cases

Paragonimiasis is a parasitic disease caused by the lung fluke, Paragonimus spp. Lung flukes may be found in various organs, such as the brain, peritoneum, subcutaneous tissues, and retroperitoneum, other than the lungs. Abdominal paragonimiasis raises a considerable diagnostic challenge to clinicians, because it is uncommon and may be confused with other abdominopelvic inflammatory diseases, particularly peritoneal tuberculosis, and peritoneal carcinomatosis. Also, subcutaneous paragonimiasis does not easily bring up clinical suspicion, due to its rarity. We herein report 2 cases of abdominal paragonimiasis and 1 case of subcutaneous paragonimiasis in Korea.

Indochinamon ou (Crustacea: Potamidae) as a New Second Intermediate Host for Paragonimus harinasutai in Luang Prabang Province, Lao PDR

Paragonimus harinasutai metacercariae were found in a species of freshwater crab, Indochinamon ou, collected in a small stream of Namback District, Luang Prabang Province, Lao PDR. Adult flukes were recovered after experimental infection of the metacercariae to dogs. Metacercariae were round or slightly elliptical, 0.666 x 0.626 mm in average size, and had a thin cyst wall of about 20 microm in thickness, a black excretory bladder, convoluted ceca, and some pinkish materials in the body. Adults were somewhat elongated, 95.2 x 36.5 mm in average size, covered with single-tipped tegumental spines, had a smaller oral sucker than the ventral sucker, a moderately branched ovary, and 5-6 lobulated testes. Eggs were ovoid and bilaterally symmetrical in shape, 79 x 45 microm in average size, and had a uniformly thickened shell. By the present study, it has been confirmed that I. ou is a new second intermediate host for P. harinasutai.

A new record of Paragonimus other than P. westermani in southern Thailand.

Field surveys of Paragonimus in Surat Thani Province, southern Thailand, revealed a new record of a lung fluke species other than P. westermani. The metacercariae were obtained from the crab, Ranguna smalleyi. The cysts of the metacercariae were spherical in shape and the larval body in the cysts contained pinkish granules. Fully mature adult worms were obtained from experimental infections with a rat and a ferret. The adult worms from the two host animals resembled each other, except for size, and had the anatomical characteristics of P. bangkokensis, ie the cuticular spines were arranged mainly in groups, the ovaries were highly branched, while the testes were more simply divided. Chromosomal preparations of the testes showed a haploid number of 11. As no sequence data of P. bangkokensis has been deposited in the GenBank/EMBL/DDBJ nucleotide database, the ITS2 region was sequenced using the metacercariae as starting material. A similarity search of P. bangkokensis ITS2 sequence using the BLAST program revealed that there was only one base difference between this population and P. harinasutai occurring in central Thailand. The result may suggest a close relationship between P. bangkokensis and P. harinasutai. This is the first description of Paragonimus species other than P. westermani occurring in southern Thailand.

Possible discovery of Chinese lung fluke, Paragonimus skrjabini in Manipur, India.

To obtain more information about Paragonimus species prevalent in Manipur, India, hundreds of freshwater crabs, Potamiscus manipurensis, were captured from mountain streams in the Motbung Mountains in Senapati District, from December 1997 to January 1998. Crab extracts were prepared by digestion, differential filtration, and sedimentation. The filtered sediments were critically examined under a stereomicroscope. Isolated Paragonimus metacercariae were used for morphological study and animal experimentation. Forty-seven metacercariae were fed orally to a 3-month-old male puppy of local breed; at autopsy 155 days after inoculation, 12 adult worms were recovered; 2 were free in the thoracic cavity and 5 pairs were in lung cysts. Two adult worms were flattened and fixed in 70% ethanol and the remaining worms were put directly into 70% ethanol and preserved until July 2005. The former 2 worms were stained with borax carmine for morphological study at Sikkim Manipal Institute of Medical Sciences, Sikkim, India. Two adult worms in the latter group were sent to the National Institute of Infectious Diseases, Tokyo, Japan, for morphological identification and DNA sequencing. The morphological features of the borax carmine-stained worms were characteristic of P. skrjabini, although no genetic material for PCR amplification and sequencing could be extracted from the worm.

Paragonimosis in the Cajabamba and Condebamba districts, Cajamarca, Peru

Stool samples from 409 pre-school and school students, living in six villages of the Cajabamba and Condebamba districts, Cajamarca, Perú, were examined using wet preparations and Lumbreras' method, looking for Paragonimus eggs. Fecal and sputum samples from two children (0.5 percent) of 6 and 8 year-old showed eggs of Paragonimus. One hundred and twenty freshwater crabs, Hypolobocera chilensis eigenmanni, were collected from the Condebamba valley and 21 (17.5 percent) of them were infected with P. mexicanus (syn. P. peruvianus) metacercariae. Our results show the persistence of Paragonimus in human beings and in the main source of infection, the crabs

Paragonimiasis pulmonar, cerebral y abdominal. Presentación de un caso de revisión de la enfermedad en Colombia / Pulmonary, cerebral and pelvic pargonimiasis. Prersentation of one case and review in Colombia

Presentamos el caso de un paciente con compromiso pulmonar, cerebral y pélvico cuyo estudio confirmó finalmente el diagnóstico de una paragonimiasis. Esta es una zoonosis (enfermedad del hombre y de los animales) causada por parásitos tremátodos del género paragonimus, que afecta pricipalmente el pulmón y otros órganos como el cerebro, el páncreas y el hígado. El parásito causante tiene un ciclo de vida que involucra moluscos y crustáceos como los cangrejos. Presenta una distribución geográfica particular en Asia y Sur América. Se había descrito desde hace muchos años en países vecinos a Colombia pero solamente en forma reciente se han publicado casos y series de casosnacionales con pacientes provenientes del Meta y de la comunidad Emberá. El caso que presentamo sirve de ilustración y de señal de alerta para considerar esta parasitosis en el diagnóstico diferencial de pacientes con enfermedad pulmonar, eosinofilia y procedencia de regiones como Chocó, Meta o Guaviare

The natural first intermediate host of Paragonimus siamensis (Miyazaki and Wykoff, 1965) in Thailand.

The first intermediate host of six-known the Paragonimus species in Thailand had not been found until the Filopaludina (Siamopaludina) martensi martensi snail was discovered to maintain the cercariae of a Paragonimus species. An extensive study examined cercarial development through to adult worms by infecting 3 genera of 7 crab species with penetration of cercariae and feeding of snails containing such cercariae. These crabs provided many metacercariae which were fed to cats and bandicoots. The animals gave many Paragonimus adult worms which were characterized as Paragonimus siamensis by the following criteria: 6-lobed ovary and cuticular spines in groups. It is concluded that the Filopaludina martensi martensi snail is a susceptable natural first intermediate host of P. siamensis. Second intermediate hosts Somanniathelphusa brandti, S. sexpunctatum and S. bangkokensis were experimentally infected; prior to this study only S. germaini and S. dugasti had ever been naturally infected with metacercariae of this species.

Paragonimiasis de presentación atípica: en un paciente pediátrico: revisión de la literatura

La paragonimiasis es una afección parasitaria que clasicamente compromete el parénquima pulmonar provocando la presencia de algunos patrones radiológicos, que aunque poco específicos deben sospecharse en sitios donde la enfermedad es endémica como en nuestro país. Es un problema clínico radiológico cuando el parásito ocupa sitios poco frecuentes como la cavidad pleural. Presentamos el caso de un paciente con localización errática en la cabidad pleural a manera de empiema que es la forma clínica más rara conocida (1 al 2por ciento).

Paragonimiasis pulmonar: informe de un caso / Pulmonary paragonimiasis. A report of an isolated case

La paragonimiasis es una enfermedad parasitaria causada por un tremátodo del género Paragonímus. Es endémica en Corea, Japón y China. En América Latina se han identificado algunos casos. En México hay 6 casos en la literatura revisada. El caso que nos ocupa es el de mujer de 41 años que ingresó al Instituto Nacional de Enfermedades Repiratorias con tos crónica, hemoptisis y pérdida de peso, a la que se practicó lobectomía superior derecha. En el estudio histopatológico se observaron lesiones granulomatosas que contenían huevecillos de Paragonimus

Infeccion natural de Ptychophallus tristani (Crustacea: Decapoda) con metacercarias de paragonimus mexicanus (Trematoda) en Tabarcia de Mora, Costa Rica / Natural infection of Ptychophallus tristani (Crustacea: Decadopa) by metacercariae of Paragonimus mexicanus (Trematoda) in Tabarcia de Mora, Costa Rica

Se determinó el grado de infección de los crustáceos Ptychophallus tristani presentes en una área endémica de Paragonimus mexicanus, encontrándose que de un total de 182 cangrejos, 161 resultaron positivos (88,5%) por metacercarias. Al comparar la infección entre machos y hembras no se encontró diferencias estadísticamente significativas y en relación a su tamaño se observó una relación directa entre tamaño y porcentaje y grado de infección. Se estableció que no existen diferencias significativas en relación a la época del año en que los cangrejos fueron capturados lo que epidemiológicamente es importante pues indica que las fuentes de infección permanecen potencialmente activas durante todo el año

Paragonimiasis humana: primera descripcion de un caso colombiano / Human paragonimiasis: first description of a colombian case.

Se describe el primer caso colombiano de Paragonimiasis humana, comprobado histopatologicamente, que afecto principalmente la base del pulmon derecho, comprometido por vecindad al hemidiafragma derecho y al higado. La enfermedad del paciente fue, muy probablemente, adquirida en Mesetas, Meta y tuvo una evolucion aproximada de 4 anos; el paciente fallecio durante el post-operatorio inmediato a la reseccion de las lesiones pleuro-pulmonares y hepaticas. La sintomatologia fue la de una neumopatia cronica con tos hemoptica y hemoptisis. A pesar de multiples baciloscopias, reiterativamente negativas para bacilo tuberculoso, el paciente se le diagnostico y trato para Tuberculosis Pulmonar. En nuestro medio, la Paragonimiasis debe ser incluida dentro del diagnostico diferencial de las neumopatias cronicas con tos hemoptoica y hemoptisis

Studies on the migratory route of Paragonimus siamensis in the bandicoot (Bandicota indica).

The migration route and the development of P. siamensis obtained from S. juliae and S. germaini were studied in B. indica. The infection rates of P. siamensis in these 2 species of crabs were 19.7% and 21.4% respectively. Worms were recovered in the abdominal cavity, pleural cavity and lungs on day 12, 16 and 30 respectively after oral infection. Worms became mature and laid eggs on day 47 after infection, but their size still increased considerably. The average egg output was found to be 144 eggs/gm faeces/worm or 443 eggs/day/worm. The average recovery rate of P. siamensis in the experimental B. indica was 15%.