Questions and Answers
What is the primary clinical feature of Paragonimiasis that can frequently lead to misdiagnosis as tuberculosis?
Which anatomical feature is characteristic of the adult Paragonimus worm?
In which part of the body do Paragonimus adults primarily provoke a granulomatous reaction?
What is the recommended sample for diagnosing Paragonimiasis?
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What potential complication may arise due to Paragonimus migration and damage in the lungs?
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Which of the following correctly describes the diagnostic stage of Paragonimus westermani?
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What is the primary first intermediate host for Paragonimus westermani?
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What characteristic distinguishes the adult Paragonimus from Fasciola, Fasciolopsis, and Echinostoma?
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Which of the following statements about the infective stage of Paragonimus westermani is correct?
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In what materials can the diagnostic stage of Paragonimus westermani typically be found?
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Study Notes
Classification of Flukes
- Blood flukes, liver flukes, intestinal flukes, and lung flukes categorized based on their habitat.
Paragonimus westermani
- Known as the oriental lung fluke.
- Infective stage: Metacercaria.
- Diagnostic stage: Unembryonated ovum.
- First intermediate host: Snail (Antemelania asperata).
- Second intermediate host: Crustaceans like crabs and crayfishes (example: Sundathelphusa philippina).
Diagnostic Stage Description
- Eggs are yellowish brown and operculated.
- Unembryonated with a thickened posterior end (abopercular end).
- Found in sputum or stool if swallowed.
Paragonimus Adult Morphology
- Body is elliptic, dorsoventrally flattened, and reddish-brown.
- Shape resembles half a peanut or coffee bean.
- Ventral sucker located centrally, while the oral sucker remains unbranched.
- Intestine is unbranched, with vitellaria extending to the tail.
Clinical Presentation
- Paragonimiasis features a persistent chronic cough with thick, brownish-red sputum.
- Symptoms include fever, myalgia, and possible hemoptysis, often confused with tuberculosis.
- Physical examination may show normal lung findings, but complications like pleural effusion and pneumothorax can occur.
Pathogenesis
- Adults induce a granulomatous reaction in the lungs leading to capsule/cyst formation filled with blood-tinged purulent material containing eggs.
- Granuloma or cyst formation can cause extrapulmonary symptoms affecting muscles, abdominal organs, genitals, brain, heart, and lymph nodes.
Migration and Development
- Adult worms escape to the peritoneal cavity, embed in the abdominal wall, and migrate to the diaphragm and pleural cavity.
- Takes 65-90 days for development in humans.
Diagnosis
- Sputum is the primary sample for diagnosis, with stool also being usable.
- Diagnostic methods may reveal eggs and sometimes adults in sputum.
- Acid-fast staining may be utilized in the diagnostic process.
Treatment and Prevention
- Praziquantel is the recommended treatment.
- Safety in pregnancy must be considered when prescribing treatment.
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Description
Explore the fascinating world of the lung fluke, specifically Paragonimus westermani. This quiz covers its classification based on habitat, lifecycle stages, and its hosts. Test your knowledge about this unique parasite and its ecological context.
