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3.
Am J Trop Med Hyg ; 96(1): 97-99, 2017 Jan 11.
Article in English | MEDLINE | ID: mdl-27879464

ABSTRACT

A 30-year-old male, from a subtropical region of Ecuador, was hospitalized with a 5-year history of persistent cough with rusty brown sputum, chest pain, and progressive dyspnea. The patient underwent thoracic surgery 3 years ago for pleural effusion and subsequently received a 9-month regimen treatment of tuberculosis. However, there was no clinical resolution and symptoms became progressively worse. A chest radiograph and computerized tomography scan showed several small nodules in both lungs. Eggs of Paragonimus spp. were observed in sputum smears, but the smears were negative for acid-fast bacilli. Molecular characterization of eggs by the internal transcribed spacer-2 regions identified them as Paragonimus mexicanus The patient was treated with praziquantel and tested negative parasitologically for 12 months. There was clinical resolution of the cough and expectoration, but dyspnea and chest pain persisted.


Subject(s)
Lung Diseases, Parasitic/pathology , Paragonimiasis/epidemiology , Paragonimiasis/pathology , Paragonimus/isolation & purification , Pleural Diseases/pathology , Adult , Animals , Ecuador/epidemiology , Humans , Lung Diseases, Parasitic/drug therapy , Lung Diseases, Parasitic/parasitology , Male , Paragonimiasis/drug therapy , Paragonimus/classification , Pleural Diseases/drug therapy , Pleural Diseases/parasitology , Praziquantel/therapeutic use
4.
Tunis Med ; 92(1): 6-11, 2014 Jan.
Article in French | MEDLINE | ID: mdl-24879163

ABSTRACT

BACKGROUND: Pulmonary hydatid disease encountered in Tunisia frequentely. Rupture of pulmonary cyst into the pleural cavity is rare, but represents the most serious complication of the hydatid disease. AIM: We analyse clinical, radiologic and outcome of intrapleural rupture of lung hydatic cyst and evaluate our experience in the surgical treatment. METHODS: We report 5 cases of rupture of rupture of pulmonary hydatid cyst into the pleural cavity hospitilazed during 1995 to 2010. RESULTS: Mean age of patients was 22,4 years. Three patients presented with hydropneumothorax, one with spontaneous pneumothorax and one with haemoptysis. The diagnosis was determined peropreratively in the first case and based on radiographic and serology findings in the other cases. Surgical treatment consist on decortication and cystotomy with capitonnage in three cases, pleurectomy one and lobectomy in the other case. Post operative course was unventful in four cases, one patient had bronchopleural fistula, pneumothorax and wound infection (parietal abssess) resolved with local treatment. After surgery, all patients were treated in post operative by 3 months course with Albendazole chemotherapy with a favourable outcome. CONCLUSION: Rupture of a pulmonary cyst into the pleural cavity is rare, but represents the most serious complication of the hydatid disease. The therapeutic progress has improved the prognosis of intrapleural ruptured hydatid cysts.


Subject(s)
Echinococcosis, Pulmonary/complications , Pleural Diseases/parasitology , Adolescent , Adult , Echinococcosis, Pulmonary/diagnostic imaging , Female , Humans , Pleural Diseases/diagnostic imaging , Radiography , Retrospective Studies , Rupture, Spontaneous/diagnostic imaging , Rupture, Spontaneous/parasitology , Young Adult
6.
Am J Med Sci ; 345(5): 385-9, 2013 May.
Article in English | MEDLINE | ID: mdl-22990049

ABSTRACT

Parasitic infections are prevalent in certain parts of the world and may cause pleural involvement, which often goes unrecognized. Common parasites involving the pleura include Entamoeba histolytica, Echinococcus granulosus and Paragonimus westermani. Amebiasis can cause empyema with "anchovy sauce" pus, reactive pleural effusions and bronchopleural fistula with hydropneumothorax. Echinococcosis may result in pleural thickening, pneumothorax, secondary pleural hydatidosis and pleural effusions. Paragonimiasis may cause chylous and cholesterol pleural effusions, pleural thickening and pneumothorax. Less commonly, pulmonary eosinophilia, or Loeffler's syndrome, caused by Ascaris lumbricoides, Ancylostoma duodenale and Necator americanus and tropical pulmonary eosinophilia caused by Wuchereria bancrofti and Brugia malayi may involve the pleura. This article provides a comprehensive review of parasitic infections involving the pleura. A high index of suspicion in the appropriate clinical setting is required to facilitate prompt diagnosis and treatment of these diseases.


Subject(s)
Parasitic Diseases/diagnosis , Parasitic Diseases/therapy , Pleura/parasitology , Pleural Diseases/diagnosis , Pleural Diseases/therapy , Animals , Humans , Pleural Diseases/parasitology
7.
J Med Liban ; 60(2): 122-4, 2012.
Article in English | MEDLINE | ID: mdl-22919872

ABSTRACT

Pleuropulmonary amebiasis is the 2nd most common extraintestinal site of amebiasis after liver abscess. We describe a man with pleuropulmonary amebiasis presenting with pulmonary consolidation and pleural effusion. In patients with pneumonia coming from endemic countries such as Lebanon, pleuropulmonary amebiasis should be considered in the setting of chocolate-colored sputum, negative respiratory cultures, and failure of antibacterial therapy.


Subject(s)
Amebiasis/diagnosis , Lung Diseases, Parasitic/diagnosis , Pleural Diseases/parasitology , Aged, 80 and over , Amebiasis/drug therapy , Antiprotozoal Agents/therapeutic use , Humans , Immunocompetence , Lung Diseases, Parasitic/drug therapy , Male , Metronidazole/therapeutic use , Pleural Diseases/diagnosis , Pleural Diseases/drug therapy , Pleural Effusion/diagnostic imaging , Pleural Effusion/etiology , Tomography, X-Ray Computed
9.
Rev Mal Respir ; 28(3): 344-7, 2011 Mar.
Article in French | MEDLINE | ID: mdl-21482338

ABSTRACT

INTRODUCTION: Hydatid cyst is a parasitic disease that is endemic in many countries. Pneumothorax may be a presentation of this disease that presents urgent problems of diagnosis and treatment. CASE REPORT: We report the case of a 23-year-old woman, amenorrheic for 22 weeks, who presented with chest pain and dyspnoea. Chest x-ray revealed a right-sided tension pneumothorax. A check x-ray after drainage showed a homogeneous opacity of water density occupying the lower 2/3 of the right hemithorax. Thoracic ultrasound suggested an uncomplicated hydatid cyst at the right base. Surgical exploration revealed a hydatid cyst 14cm in diameter in the pleural space, and a cavity in the right lower lobe with two bronchial fistulae. Treatment consisted of removal of the cyst intact, closure of the bronchial fistulae and capitonnage of the residual cavity. The postoperative course was uncomplicated. CONCLUSION: Primary heterotopic pleural hydatid cyst is an exceptional cause of pneumothorax that should considered in countries where hydatid disease is endemic. Treatment is surgical following drainage of the pneumothorax.


Subject(s)
Bronchial Fistula/parasitology , Echinococcosis, Pulmonary/complications , Echinococcus , Pleural Diseases/parasitology , Pneumothorax/parasitology , Adult , Animals , Bronchial Fistula/diagnosis , Bronchial Fistula/surgery , Drainage , Echinococcosis, Pulmonary/diagnosis , Echinococcosis, Pulmonary/surgery , Echinococcus/isolation & purification , Female , Humans , Pleural Diseases/diagnosis , Pleural Diseases/surgery , Pneumonectomy , Pneumothorax/diagnosis , Pneumothorax/surgery , Treatment Outcome
10.
South Med J ; 103(2): 165-8, 2010 Feb.
Article in English | MEDLINE | ID: mdl-20175253

ABSTRACT

Pleuropulmonary amebiasis is an uncommon complication of Entamoeba histolytica infection. It typically occurs in endemic regions including Central and South America, Africa and the Indian subcontinent. The case of a previously healthy US Army male stationed in Liberia with an acute onset of fevers, abdominal pain and bloody diarrhea is presented. He developed a productive cough with pleuritic chest pain and imaging revealed multiple liver abscesses, with rupture through the diaphragm causing a large right pleural empyema. A positive Entamoeba histolytica serum antibody and pleural fluid antigen confirmed the diagnosis. Surgical drainage of the pleural empyema and medical treatment with antiparasitics were necessary for symptom and disease resolution.


Subject(s)
Dysentery, Amebic/diagnosis , Dyspnea/parasitology , Entamoebiasis/diagnosis , Pleural Diseases/parasitology , Antiprotozoal Agents/therapeutic use , Dysentery, Amebic/drug therapy , Dyspnea/drug therapy , Entamoeba histolytica , Entamoebiasis/drug therapy , Humans , Lung Diseases, Parasitic/diagnosis , Lung Diseases, Parasitic/drug therapy , Male , Metronidazole/therapeutic use , Middle Aged , Pleural Diseases/drug therapy
11.
Ann Thorac Cardiovasc Surg ; 16(6): 436-8, 2010 Dec.
Article in English | MEDLINE | ID: mdl-21263427

ABSTRACT

Pleuropulmonary paragonimiasis is a food-borne parasitic disease caused by the lung fluke Paragonimus westermani or other species of Paragonimus, which is endemic in Southeast Asia. It presents mainly pleural effusion or intrapulmonary nodules with respiratory symptoms. However, here we describe an exceedingly rare case of Paragonimus westermani with a mass in the pleural cavity. A 47-year-old man, who had presented with chest pain nine months earlier, was found to have right pleural effusion on detection survey computed tomography. He had a history of asbestos exposure and river fishing as a hobby and was confirmed to have Paragonimus westermani by immunodiagnosis. Because of a high level of hyaluronic acid in pleural effusion, he underwent a thoracoscopic examination. The pleura of the thoracic wall thickened greatly and showed no malignant lesion on biopsy. A white mass measuring 8 cm in diameter showed in the pleural cavity, which partially connected with the diaphragm and pulmonary pleura of the lower lobe. The postoperative pathological examination reported that the intrathoracic mass was a lesion that contained necrotic tissue enveloped with a fibrin capsule, which was thought to be formed by paragonimus.


Subject(s)
Lung Diseases, Parasitic/diagnosis , Paragonimiasis/diagnosis , Paragonimus westermani , Pleural Diseases/diagnosis , Animals , Humans , Lung Diseases, Parasitic/parasitology , Lung Diseases, Parasitic/therapy , Male , Middle Aged , Paragonimiasis/therapy , Pleural Diseases/parasitology , Pleural Diseases/therapy
12.
Turkiye Parazitol Derg ; 33(2): 177-8, 2009.
Article in English | MEDLINE | ID: mdl-19598100

ABSTRACT

Hydatid cyst has a predilection to locate in liver, lungs, and brain. Intrathoracic extrapulmonary locations are generally the mediastinum, pleura, pericardium and chest wall. Pleural involvement usually follows the rupture of a pulmonary or hepatic cyst inside the pleural space causing secondary pleural hydatidosis. Radiological investigations of a patient suffering from cough and dyspnea revealed multiple cysts located in the posterior lower right hemithorax, and implanted in the diaphragmatic pleura and parietal pleura lining the chest wall. He had undergone two hepatic hydatid cystectomy operations. These multiple cysts were removed by thoracotomy. The possibility of secondary pleural dissemination should be considered in patients with lobulated cystic masses as well as a previous hepatic cystic hydatid disease.


Subject(s)
Echinococcosis/diagnosis , Pleural Diseases/diagnosis , Aged , Albendazole/therapeutic use , Anticestodal Agents/therapeutic use , Echinococcosis/drug therapy , Echinococcosis/surgery , Humans , Magnetic Resonance Imaging , Male , Pleural Diseases/drug therapy , Pleural Diseases/parasitology , Pleural Diseases/surgery , Secondary Prevention , Tomography, X-Ray Computed
14.
Trans R Soc Trop Med Hyg ; 101(8): 786-92, 2007 Aug.
Article in English | MEDLINE | ID: mdl-17467757

ABSTRACT

In the northeastern region of India, paragonimiasis is emerging as an important public health problem. However, until now the identity of the species causing human infection has been uncertain and there has been little information on the prevalence and clinicoradiological features of infection in the community. Parasitological and immunological surveys revealed that paragonimiasis was hyperendemic in parts of Arunachal Pradesh. Egg positivity in the sputum was 20.9% and 4.1% in children (age 15 years), respectively. Antibody positivity against excretory-secretory antigen of the adult worm in children and adults was 51.7% and 18.7%, respectively. Chronic cough (97.2%) and haemoptysis (83.3%) were common respiratory symptoms among egg-positive cases. Chest radiography (n=68) images from egg-positive cases showed that air space consolidation (75%), cavitary lesions (14.7%) and mediastinal adenopathy (11.8%) were very frequent. Less frequent findings were nodular lesions, bronchiectasis, mediastinal adenopathy, pleural thickening and pleural effusion. DNA extracted from eggs from the sputum of patients from Arunachal Pradesh was sequenced. Analyses of the second internal transcribed spacer (ITS2) of nuclear rDNA revealed that the species responsible is Paragonimus heterotremus.


Subject(s)
Lung Diseases, Parasitic/diagnosis , Paragonimiasis/diagnosis , Paragonimus/isolation & purification , Shellfish/parasitology , Sputum/parasitology , Adolescent , Adult , Animals , Communicable Diseases, Emerging/epidemiology , Female , Humans , India/epidemiology , Lung Diseases, Parasitic/diagnostic imaging , Lung Diseases, Parasitic/epidemiology , Male , Paragonimiasis/diagnostic imaging , Paragonimiasis/epidemiology , Paragonimus/classification , Pleural Diseases/parasitology , Prevalence , Radiography , Shellfish/adverse effects
15.
Rev Pneumol Clin ; 62(6 Pt 1): 386-9, 2006 Dec.
Article in French | MEDLINE | ID: mdl-17242644

ABSTRACT

OBJECTIVE: To report our experience in the management of intra-thoracic extra-pulmonary hydatid cyst, and to discuss the etio-pathogeny of this affection. PATIENTS AND METHODS: Among 80 patients who underwent surgery in our department for intra-thoracic hydatid cysts between September 2001 and September 2005, six patients (7.5%) had an extra-pulmonary localization. There were 4 men and 2 women with a mean age of 43 years. The lesions were pleural, diaphragmatic or mediastinal. Thoracotomy was performed in all patients. RESULTS: One patient had multiple localizations (diaphragm, anterior mediastinum and pleura). The cyst was simple in 5 cases and complicated (rupture) in one case. The diagnosis of hydatid cyst was suspected on the basis of the radiological data and confirmed intra-operatively. No complications or recurrences were observed during the follow-up period. CONCLUSION: Intra-thoracic extra-pulmonary hydatid cyst is uncommon even in endemic countries such as Morocco. Surgery is the best treatment and must be proposed early in order to prevent complications. Medical treatment is reserved for complicated forms.


Subject(s)
Diaphragm , Echinococcosis/diagnosis , Mediastinal Diseases/parasitology , Pleural Diseases/parasitology , Adult , Diaphragm/diagnostic imaging , Diaphragm/surgery , Echinococcosis/surgery , Female , Humans , Male , Mediastinal Diseases/diagnostic imaging , Mediastinal Diseases/surgery , Pleural Diseases/diagnostic imaging , Pleural Diseases/surgery , Radiography , Retrospective Studies , Thoracotomy , Treatment Outcome
16.
Presse Med ; 34(19 Pt 1): 1371-2, 2005 Nov 05.
Article in French | MEDLINE | ID: mdl-16292189

ABSTRACT

INTRODUCTION: Trichomonas is a protozoan rarely incriminated in pulmonary or pleural disorders. CASE: An 84-year-old man, under treatment for chronic lymphoid leukemia with hypogammaglobulinemia, was hospitalized for respiratory distress and fever due to bilateral pulmonary and pleural disorders. Direct examination of the bronchoalveolar lavage fluid revealed a flagella protozoan identified as Trichomonas tenax. DISCUSSION: Although Trichomonas is rare in pulmonary disorders, when it occurs, T. tenax appears to be the most common species. Treatment with metronidazole was effective.


Subject(s)
Lung Diseases, Parasitic/diagnosis , Pleural Diseases/parasitology , Trichomonas Infections/diagnosis , Trichomonas/isolation & purification , Aged, 80 and over , Animals , Antiprotozoal Agents/therapeutic use , Humans , Lung Diseases, Parasitic/drug therapy , Male , Metronidazole/therapeutic use , Pleural Diseases/drug therapy , Trichomonas Infections/drug therapy
17.
Med Mal Infect ; 35(10): 476-81, 2005 Oct.
Article in French | MEDLINE | ID: mdl-16253459

ABSTRACT

Paragonimiasis is a food borne zoonosis due to a trematode belonging to the genus Paragonimus. Although present throughout the world, about 90% of the cases occur in Asia where around 20 million people are infected. The parasitic cycle is complex with two different intermediate hosts. Man is infected by ingesting the raw or undercooked flesh of the second host - a freshwater crab or prawn - or possibly of a paratenic mammal host (wild boar), which contains the infective larval stage metacercariae that reaches the lung which is the main target organ. Epidemiological, pathological, and clinical aspects are reviewed. The main symptoms are protracted cough, and recurrent "benign" hemoptysis. Abnormal pleuro-pulmonary imaging features are constant, but protean and non-specific, leading to frequent confusion with tuberculosis. Diagnosis is easily achieved by ova search in the sputum or pleural fluid, or by serology. Evolution is usually considered benign, although not well known. Finally, praziquantel is the effective first choice treatment. Some paradoxical aspects of this disease are underlined such as: underdiagnosis despite a very simple diagnostic procedure, or opposite tendencies according to location, either extinction or re-emergence.


Subject(s)
Anthelmintics/therapeutic use , Lung Diseases/parasitology , Paragonimiasis/transmission , Pleural Diseases/parasitology , Praziquantel/therapeutic use , Animals , Cooking , France/epidemiology , Humans , Lung Diseases/drug therapy , Lung Diseases/epidemiology , Paragonimiasis/diagnosis , Paragonimiasis/drug therapy , Paragonimiasis/epidemiology , Paragonimus/growth & development , Pleural Diseases/diagnosis , Pleural Diseases/drug therapy , Pleural Diseases/epidemiology , Seafood/parasitology
19.
Rev Mal Respir ; 22(6 Pt 1): 1035-7, 2005 Dec.
Article in French | MEDLINE | ID: mdl-16217543

ABSTRACT

INTRODUCTION: Pleuropulmonary involvement is the second most common extra-intestinal manifestation of entamoeba histolytica infection after liver abscess. CASE REPORT: We report 2 cases of pleuropulmonary disease occurring in two men aged 32 and 48 years following an episode of dysentery. Purulent pleural infection was noted in one case. In the other both lung and liver abscesses occurred. CONCLUSION: The diagnosis was confirmed by strongly positive serology in both cases. Treatment with metronidazole (1.5 g per day) for 15 days combined with pleural drainage led to a satisfactory outcome in both cases.


Subject(s)
Entamoeba histolytica , Entamoebiasis , Liver Abscess, Amebic , Lung Abscess/parasitology , Lung Diseases/parasitology , Pleural Diseases/parasitology , Adult , Animals , Antiprotozoal Agents/administration & dosage , Antiprotozoal Agents/therapeutic use , Drainage , Entamoebiasis/diagnosis , Entamoebiasis/drug therapy , Humans , Liver Abscess, Amebic/diagnosis , Liver Abscess, Amebic/drug therapy , Lung Abscess/drug therapy , Lung Diseases/diagnostic imaging , Lung Diseases/drug therapy , Male , Metronidazole/administration & dosage , Metronidazole/therapeutic use , Middle Aged , Pleural Diseases/diagnostic imaging , Pleural Diseases/drug therapy , Radiography, Abdominal , Radiography, Thoracic , Tomography, X-Ray Computed , Treatment Outcome
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