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Abstract
Pleural paragonimiasis is uncommon in the pediatric population and therefore can be challenging to diagnose. This is a case of a 6-year-old girl with pleural effusion who had been having intermittent persistent epigastric pain and erythematous rash on the face, hands, and arms for 6 months. Exudative pleural effusion with prominent eosinophils and serum eosinophilia were observed. As patient showed high immuno globulin M (IgM) titers against Mycoplasma pneumoniae, she was treated with antibiotics; however, the pleural effusion did not improve during hospitalization. Despite showing negative stool ova and cyst results, patient's serum and pleural effusion were positive for Paragonimus westermani-specific IgGs on enzyme-linked immunosorbent assay. Respiratory symptoms, pleural effusion, and skin symptoms improved after praziquantel treatment.
References
1. Song JH, Dai F, Bai X, Kim TI, Yang HJ, Kim TS, et al. Recent incidence of Paragonimus westermani metacercariae in freshwater crayfish, Cambaroides similis, from two enzootic sites in Jeollanam-do, Korea. Korean J Parasitol. 2017; 55:347–50.
2. Kim TI, Oh SR, Dai F, Yang HJ, Ha SD, Hong SJ. Inactivation of Paragonimus westermani metacercariae in soy sauce-marinated and frozen freshwater crabs. Parasitol Res. 2017; 116:1003–6.
3. Doanh PN, Horii Y, Nawa Y. Paragonimus and paragonimiasis in Vietnam: an update. Korean J Parasitol. 2013; 51:621–7.
4. Hwang KE, Song HY, Jung JW, Oh SJ, Yoon KH, Park DS, et al. Pleural fluid characteristics of pleuropulmonary paragonimiasis masquerading as pleural tuberculosis. Korean J Intern Med. 2015; 30:56–61.
5. Ferreiro L, Sanchez-Sanchez R, Valdes L, Kummerfeldt CE, Huggins JT. Concordant and discordant exudates and their effect on the accuracy of light's criteria to diagnose exudative pleural effusions. Am J Med Sci. 2016; 352:54956.
6. Diny NL, Rose NR, Cihakova D. Eosinophils in autoimmune diseases. Front Immunol. 2017; 8:484.
7. Freeman AF, Olivier KN. Hyper-IgE syndromes and the lung. Clin Chest Med. 2016; 37:557–67.
8. Oba Y, Abu-Salah T. The prevalence and diagnostic significance of eosinophilic pleural effusions: a metaanalysis and systematic review. Respiration. 2012; 83:198–208.
9. Xia Y, Ju Y, Chen J, You C. Cerebral paragonimiasis: a retrospective analysis of 27 cases. J Neurosurg Pediatr. 2015; 15:101–6.
10. Ashitani J, Kumamoto K, Matsukura S. Paragonimiasis westermani with multifocal lesions in lungs and skin. Intern Med. 2000; 39:433–6.
11. Sim YS, Lee JH, Hong SC, Chang JH, Kang SR, Yang HJ, et al. Paragonimus westermani found in the tip of a little finger. Intern Med. 2010; 49:1645–8.
12. Shafritz AB, Coppage JM. Acute and chronic paronychia of the hand. J Am Acad Orthop Surg. 2014; 22:165–74.
13. Azkur D, Civelek E, Toyran M, Msrlolu ED, Erkoolu M, Kaya A, et al. Clinical and etiologic evaluation of the children with chronic urticaria. Allergy Asthma Proc. 2016; 37:450–7.
14. Chai JY. Paragonimiasis. Handb Clin Neurol. 2013; 114:283–96.
15. Lee SH, Kim MN, Back BY, Choi JY, Kim TH, Hwang YS. Analysis of parasite-specific-antibody positive patients for clonorchis sinensis, paragonimus westermani, cysticercus and sparganum using ELISA. Korean J Lab Med. 2003; 23:126–31.
16. Lee MK, Hong SJ, Kim HR. Seroprevalence of tissue invading parasitic infections diagnosed by ELISA in Korea. J Korean Med Sci. 2010; 25:1272–6.
17. Intapan PM, Sanpool O, Janwan P, Laummaunwai P, Morakote N, Kong Y, et al. Evaluation of IgG4 subclass antibody detection by peptide-based ELISA for the diagnosis of human paragonimiasis heterotrema. Korean J Parasitol. 2013; 51:763–6.
18. Hu Y, Qian J, Yang D, Zheng X. Pleuropulmonary paragonimiasis with migrated lesions cured by multiple therapies. Indian J Pathol Microbiol. 2016; 59:56–8.
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