ABSTRACT
We report the case of a 33-year-old patient who presented with dyspnea and hemoptysis due to an oropharyngeal leech infestation. The patient was a shepherd and his detailed history revealed that he had been drinking water from natural springs. In the examination, a vivid dark green colored foreign body moving towards the nasopharynx and hypopharynx was detected in the oropharynx. The leech was removed under local anesthesia by gently grasping with the help of a long clamp. It should be noted that leeches are common in rural water sources and they can cause severe morbidity and even mortalities due to serious complications such as severe anemia and airway obstructions. A thorough oral and oropharyngeal examination will be sufficient to identify such cases, indicating the importance of physical examination in patients that present with otherwise unexplained airway obstruction and hemoptysis.
Subject(s)
Agricultural Workers' Diseases/parasitology , Airway Obstruction/parasitology , Hemoptysis/parasitology , Leeches/physiology , Natural Springs/parasitology , Oropharynx/parasitology , Adult , Animals , Drinking , Foreign Bodies/diagnosis , Humans , Leeches/pathogenicity , MaleABSTRACT
Horace N. Allen, an American physician, was a Presbyterian missionary to Korea. In 1886, he wrote the annual report of the Korean government hospital, summarizing patient statistics according to outpatient and inpatient classification for the first ever in Korean history. In the report, he speculated that hemoptysis cases of outpatient might have been mainly caused by distoma. Allen's conjecture was noteworthy because only a few years lapsed since the first scientific report of paragonimiasis. However, he was not sure of his assumption either because it was not evidently supported by proper microscopic or post-mortem examinations. In this letter, we thus revisit his assumption with our parasitological data recently obtained from Joseon period mummies.
Subject(s)
Archaeology/history , Helminthiasis/history , Helminths/isolation & purification , Hemoptysis/history , Parasitology/history , Animals , Autopsy , Helminthiasis/diagnosis , Helminthiasis/epidemiology , Helminthiasis/parasitology , Helminths/cytology , Hemoptysis/diagnosis , Hemoptysis/epidemiology , Hemoptysis/parasitology , History, 18th Century , History, 19th Century , Humans , Mummies/parasitology , Ovum/cytology , Prevalence , Republic of Korea/epidemiologyABSTRACT
CASE PRESENTATION: A man in his 20s presented with 2 months of mild fatigue and intermittent hemoptysis of less than a tablespoon per episode. He was previously healthy and was on no medications. He denied fevers, night sweats, weight loss, wheezing, dyspnea, musculoskeletal symptoms, and rashes. He had emigrated from a South American country to the United States 3 years earlier. He worked as a groundskeeper but had no exposures to animals, mold, or dusts. He reported rare prior cigarette smoking with no history of alcohol or drug use. He was unsure whether he had received the Bacillus Calmette-Guérin vaccine.
Subject(s)
Lung Diseases, Parasitic/diagnosis , Paragonimiasis/diagnosis , Adult , Antinematodal Agents/therapeutic use , Diagnosis, Differential , Dyspnea/parasitology , Hemoptysis/parasitology , Humans , Lung Diseases, Parasitic/drug therapy , Male , Paragonimiasis/drug therapy , Praziquantel/therapeutic use , Tomography, X-Ray Computed , Tuberculosis, Pulmonary/diagnosisABSTRACT
Foreign bodies in the upper respiratory tract are one of the most difficult otolaryngological emergencies; leeches are a very rare foreign bodies in the world. We report the case of a 70-year-old man with no past medical history presenting with laryngeal dyspnea associated with low abundant paroxysmal hemoptysis. The patient underwent nasofibroscopy showing the presence of a living and mobile organism at the subglottic level evoking a leech. Extraction was carried out under local anesthesia using laryngoscope and Magill forceps. The presence of a leech as a foreign body in the upper respiratory tract should be suspected in patients with a recent history of consumption of non-potable water.
Subject(s)
Foreign Bodies/parasitology , Hemoptysis/parasitology , Larynx/parasitology , Leeches , Aged , Anesthesia, Local/methods , Animals , Dyspnea/etiology , Foreign Bodies/diagnosis , Humans , Laryngoscopy/methods , MaleABSTRACT
The authors report a case of coinfection of pulmonary paragonimiasis and pulmonary tuberculosis which is an uncommon coinfection. The patient presented with a one-week history of nonmassive hemoptysis about 1 month after completion of treatment for smear-negative pulmonary tuberculosis (sputum polymerase chain reaction positive for Mycobacterium tuberculosis). She lived in Nakhon Nayok province and reported taking raw crabs from time to time. The complete blood count revealed eosinophilia and her chest radiograph showed patchy infiltration at right lower lung field. Computed tomography scan of the chest revealed consolidation with internal air bubbles at anterobasal segment of right lower lobe. The diagnosis of pulmonary paragonimiasis was confirmed by detecting eggs of the genus Paragonimus in her wet-mount sputum. She was treated with oral praziquantel for 3 consecutive days with improvement. To our knowledge, although coinfection of pulmonary paragonimiasis and pulmonary tuberculosis is rare, it should be considered as the differential diagnosis in patients who live in the endemic area presenting with hemoptysis and eosinophilia.
Subject(s)
Coinfection/diagnosis , Eosinophilia/diagnosis , Hemoptysis/diagnosis , Lung/diagnostic imaging , Paragonimiasis/diagnosis , Tuberculosis, Pulmonary/diagnosis , Adult , Animals , Antiplatyhelmintic Agents/therapeutic use , Coinfection/microbiology , Coinfection/parasitology , Diagnosis, Differential , Eosinophilia/drug therapy , Eosinophilia/parasitology , Female , Hemoptysis/drug therapy , Hemoptysis/parasitology , Humans , Lung/microbiology , Lung/parasitology , Mycobacterium tuberculosis/physiology , Paragonimiasis/drug therapy , Paragonimiasis/parasitology , Paragonimus/isolation & purification , Praziquantel/therapeutic use , Sputum/parasitology , Thailand , Tomography, X-Ray Computed , Treatment Outcome , Tuberculosis, Pulmonary/diagnostic imaging , Tuberculosis, Pulmonary/microbiologySubject(s)
Bronchoscopy/methods , Hemoptysis/parasitology , Leeches , Pharynx/parasitology , Animals , Child , Female , Humans , Laryngoscopy , Middle Aged , Suction , Treatment OutcomeABSTRACT
Leeches live in fresh water and moist terrestrial environments. Most infestations are cutaneous. However, internal infestation occurs principally in the rural parts of the Mediterranean countries as well as in Africa and Asia. Thus,the possibility of leech endoparasitism should be kept in mind for a patient presenting with hemoptysis and with a history of close contact with fresh water in tropical countries.Human infestation is rare and usually occurs after consumption of contaminated water or swimming in leech-infested still waters such as lakes and dams.Herein, we report 2 live leech cases with hemoptysis in the supraglottic region of the larynx.
Subject(s)
Hemoptysis/parasitology , Laryngeal Diseases/parasitology , Leeches , Adolescent , Adult , Animals , Humans , Male , Water/parasitologySubject(s)
Echinococcosis, Pulmonary/surgery , Thoracoscopy , Adolescent , Chest Pain/parasitology , Child , Child, Preschool , Cough/parasitology , Eosinophilia/parasitology , Female , Fever/parasitology , Hemoptysis/parasitology , Hospitals, University , Humans , Leukocytosis/parasitology , Male , Morocco , Postoperative Complications , Retrospective StudiesSubject(s)
Dirofilaria immitis/growth & development , Dirofilariasis/parasitology , Dog Diseases/parasitology , Hemoptysis/veterinary , Animals , Dirofilariasis/drug therapy , Dirofilariasis/physiopathology , Dog Diseases/drug therapy , Dog Diseases/physiopathology , Dogs , Fatal Outcome , Female , Hemoptysis/parasitology , MaleABSTRACT
OBJECTIVE: Hydatid cyst disease is caused by the metacestod form of Echinococcosis granulosus from cestods. Pulmonary hydatid cyst is the second most frequent form of the disease after the liver involvement and may open into the bronchial or pleural space by perforation and may cause complications. The aim of the study was to evaluate the clinical features and the frequency of the complicated pulmonary hydatid cyst disease. METHODS: Fifteen hydatid cyst patients were evaluated according to socio-demographical, clinical and radiological findings between 2009 and 2011 retrospectively. Hydatid cyst diseases were diagnosed histopathologically after chest surgery. Diagnostic difficulties and clinical features were analysed in four complicated pulmonary hydatid cyst cases. RESULTS: Pneumothorax, pleural effusion, lung abscess, and hemoptysis were observed in four complicated cases. The complicated cases were diagnosed after surgery. Eleven of lung cysts were intact, radiological and histopathological features were typical for images of hydatid cyst disease and reported as compatible with the clinical diagnosis. A synchronized liver and pulmonary hydatid cyst was evaluated as a morbidity factor. CONCLUSION: Hydatid cyst should be considered in the differential diagnosis of uncertain chest pathologies, especially in rural areas where the disease is endemic.
Subject(s)
Echinococcosis, Pulmonary/pathology , Echinococcus granulosus , Adolescent , Adult , Aged , Animals , Diagnosis, Differential , Echinococcosis, Pulmonary/diagnostic imaging , Echinococcosis, Pulmonary/epidemiology , Echinococcosis, Pulmonary/surgery , Female , Hemoptysis/parasitology , Humans , Lung Abscess/parasitology , Male , Middle Aged , Pleural Effusion/parasitology , Pneumothorax/parasitology , Radiography , Retrospective Studies , Socioeconomic Factors , Turkey/epidemiology , Young AdultABSTRACT
This paper presents a 73 years old male with three weeks history of intermittent hemoptysis, dysphagia, dyspnea, stridor, and suffocations sensation. By means of fibrotic bronchoscopic examination, the cause was found to be a leech in the glottis. It was removed by injection of 4 ml lidocaine 2%. Infestation into the respiratory tract by a leech may become lethal because of hypoxia and death secondary to airway obstruction. A high index of suspicion of leech infestation sould be considered in patients presenting with hemoptysis, hoarseness and respiratory distress and a history of recent contact with fresh water streams.
Subject(s)
Airway Obstruction/parasitology , Foreign Bodies/parasitology , Glottis/parasitology , Hemoptysis/parasitology , Leeches , Aged , Airway Obstruction/surgery , Animals , Foreign Bodies/diagnosis , Foreign Bodies/surgery , Glottis/surgery , Hemoptysis/surgery , Hoarseness/parasitology , Humans , Laryngoscopy , Male , Respiratory Sounds/etiology , Treatment OutcomeABSTRACT
An 8-year-old girl was admitted to the emergency department with hemoptysis. Her history revealed that she had been drinking unfiltered tap water several days before. Physical examination revealed a black live foreign object in the pharynx with local posterior pharyngeal oozing. Pharyngeal leech was suspected and removed immediately using forceps. After removal of the leech, the bleeding stopped immediately and the patient felt comfortable. The leech was identified as belonging to the species Limnatis nilotica. Pharyngeal leeches should be included in the differential diagnosis of patients with hemoptysis, especially in patients with a history of drinking unfiltered water from sources where aquatic leeches are commonly found. Cases such as this should be considered as emergencies, and all measures should be taken to avoid hemoptysis and death.
Subject(s)
Hemoptysis/parasitology , Leeches/physiology , Pharynx/parasitology , Animals , Bacterial Infections/prevention & control , Child , Female , Humans , Metronidazole/therapeutic useABSTRACT
Paragonimiasis (human infections with the lung fluke Paragonimus westermani) is an important public health problem in parts of Southeast Asia and China. Paragonamiasis has rarely been reported from North America as a zoonosis caused by Paragonimus kellicotti. Paragonimus species have complex life cycles that require 2 intermediate hosts, namely, snails and crustaceans (ie, crabs or crayfish). Humans acquire P. kellicotti when they consume infected raw crayfish. Humans with paragonimiasis usually present with fever and cough, which, together with the presentation of hemoptysis, can be misdiagnosed as tuberculosis. Only 7 autochthonous cases of paragonimiasis have been previously reported from North America. Our study describes 3 patients with proven or probable paragonimiasis with unusual clinical features who were seen at a single medical center during an 18-month period. These patients acquired their infections after consuming raw crayfish from rivers in Missouri. It is likely that other patients with paragonimiasis have been misdiagnosed and improperly treated. Physicians should consider the possibility that patients who present with cough, fever, hemoptysis, and eosinophilia may have paragonimiasis.
Subject(s)
Astacoidea/parasitology , Lung Diseases, Parasitic/diagnosis , Paragonimiasis/diagnosis , Paragonimus westermani , Shellfish/parasitology , Adult , Animals , Anthelmintics/therapeutic use , Diagnosis, Differential , Female , Food Contamination , Food Parasitology , Hemoptysis/diagnosis , Hemoptysis/parasitology , Humans , Lung Diseases, Parasitic/drug therapy , Lung Diseases, Parasitic/epidemiology , Male , Missouri/epidemiology , Paragonimiasis/drug therapy , Paragonimiasis/epidemiology , Praziquantel/therapeutic use , Tuberculosis/diagnosisSubject(s)
Aortic Diseases/complications , Bronchial Fistula/complications , Echinococcosis, Pulmonary/complications , Hemoptysis/parasitology , Vascular Fistula/complications , Albendazole/therapeutic use , Animals , Anthelmintics/therapeutic use , Aorta, Thoracic/pathology , Aortic Diseases/parasitology , Bronchial Fistula/parasitology , Echinococcosis, Pulmonary/drug therapy , Echinococcosis, Pulmonary/surgery , Female , Humans , Middle Aged , Vascular Fistula/parasitologyABSTRACT
Leech infestation can cause many different clinical symptoms such as epistaxis, haemoptysis, haematemesis, and vaginal bleeding. Therefore leech infestation should be considered as a cause of unexplained severe anemia in rural areas where aquatic leeches are common. In this paper we report a case of pharyngeal leech infestation (Limnatis nilotica) presenting with haemoptysis, and epistaxis which resulted in difficulty in making a diagnosis.
Subject(s)
Anemia/etiology , Epistaxis/parasitology , Hemoptysis/parasitology , Leeches/pathogenicity , Parasitic Diseases/complications , Pharynx/parasitology , Animals , Child, Preschool , Diagnosis, Differential , Epistaxis/complications , Female , Hemoptysis/complications , Humans , Leeches/classification , Parasitic Diseases/diagnosisSubject(s)
Bronchoalveolar Lavage Fluid/parasitology , Hemoptysis/parasitology , Paragonimiasis/diagnosis , Adult , Animals , Anthelmintics/therapeutic use , Emigrants and Immigrants , Hemoptysis/etiology , Humans , Male , Myanmar , Paragonimiasis/complications , Paragonimiasis/drug therapy , Praziquantel/therapeutic useABSTRACT
A 49-year-old female patient who had undergone surgery for hepatic echinococcosis five years previously was admitted with haemoptysis. MRI angiography showed total occlusion of the left inferior pulmonary artery. Echocardiography showed no pulmonary hypertension. The patient underwent pneumonectomy and cysts in the left pulmonary artery were observed. Pulmonary artery involvement should be considered in patients who have undergone hepatic cyst surgery if haemoptysis is the first presenting symptom, especially in endemic regions for hydatidosis.
Subject(s)
Echinococcosis, Pulmonary/drug therapy , Hemoptysis/diagnosis , Pulmonary Artery/pathology , Pulmonary Embolism/drug therapy , Albendazole/therapeutic use , Anthelmintics/therapeutic use , Echinococcosis, Pulmonary/surgery , Female , Hemoptysis/parasitology , Humans , Middle Aged , Pulmonary Artery/parasitology , Pulmonary Embolism/parasitologyABSTRACT
INTRODUCTION: Pulmonary infestation with Strongyloides stercoralis is an exceptionally rare cause of haemoptysis, the diagnosis being difficult and often delayed. CASE REPORT: We report the case of a retired coal miner suffering from pneumoconiosis who presented with acute respiratory insufficiency and massive haemoptysis, with a fatal outcome, associated with pulmonary stongyloidosis. The only identified source of infestation with Strongyloides stercoralis was his period in the coal mine and the only risk factors for the hyperinfestation were a short course of systemic corticosteroid therapy and the presence of a peritoneal-auricular valve. CONCLUSION: This observation illustrates the importance of a systematic search for anguillosis in ex coal miners prior to any immunosuppressant treatment in order to avoid the serious and frequently fatal form of hyperinfestation with Strongyloides stercoralis.
Subject(s)
Hemoptysis/parasitology , Lung Diseases, Parasitic/diagnosis , Strongyloidiasis/diagnosis , Aged , Animals , Coal Mining , Fatal Outcome , Humans , Male , Respiratory Insufficiency/parasitology , Strongyloides stercoralis/isolation & purificationABSTRACT
Pulmonary hydatid cyst is exceptional in our country. The diagnosis is generally established on the basis of imaging. Surgical treatment is indicated in most patients. We report a case of pulmonary hydatid cyst in a 74-year-old smoker (11 package-years) who presented cough with mucopurulent expectoration and occasional hemoptysis. The chest x-ray demonstrated a poorly delimited heterogeneous opacity in the upper third of the left lung which persisted after antibiotic therapy. Bronchial fibroscopy revealed a hydatid membrane in the left superior bronchus which was totally removed by aspiration. A control radiography after the fibroscopy demonstrated a clear regression of the opacity. A thoracic CT-scan was performed and revealed a residual cavity in the left upper lobe with bronchial dilatation. The indication for surgery was not retained. Treatment of pulmonary hydatid cyst by endoscopy is an exceptional event. Our exceptional case illustrates an atypical radiological presentation and the use of "therapeutic" fibroscopy.
Subject(s)
Bronchoscopy , Echinococcosis, Pulmonary/surgery , Aged , Animals , Cough/parasitology , Echinococcosis, Pulmonary/diagnosis , Hemoptysis/parasitology , Humans , MaleABSTRACT
INTRODUCTION: The lung is the most frequent location of hydatid cysts (HC). Cardiac and vascular HC are rare, and the primary location in the pulmonary artery is exceptional. OBSERVATIONS: We report three cases of right cardiac HC cyst revealed by pulmonary hydatidosis, and 1 case of a primary HC of the pulmonary artery revealed by haemoptysis. Treatment consisted in surgical resection of the cardiac and pulmonary artery HC. Post-surgical antiparasite chemotherapy, based on albendazole, was prescribed for all patients. The evolution was towards a post pneumonectomy syndrome in the patient with a HC in the pulmonary artery, major pulmonary hypertension in the case of pulmonary embolic hydatidosis and an extension of the hydatid lesions in the third patient. Treatment is ongoing in the fourth patient with the development of many parenchymatous cysts. DISCUSSION: Cardiac and vascular hydatid cysts are rare and of bad prognosis. These cardiac and vascular cysts are of poor prognosis because of the risk of rupture and hematogenic dissemination. Treatments are only partially effective and more importance should be given to preventive treatment.