Paragonimiasis Lecture PDF 2024 - Medical Science

Paragonimiasis Module: Cardiopulmonary Dr. Mohammed Elfaki Department of Basic Medical science 2024 ‫كلية الطب‬  Background  Trematodes (flatworm) of the Paragonimus genus cause paragonimiasis  A parasitic disease, parasitic wor...

Paragonimiasis Module: Cardiopulmonary Dr. Mohammed Elfaki Department of Basic Medical science 2024 ‫كلية الطب‬  Background  Trematodes (flatworm) of the Paragonimus genus cause paragonimiasis  A parasitic disease, parasitic worm also called a fluke or lung fluke because it commonly infects the lungs  10 or more Paragonimus species that are human pathogens  The most common is the lung fluke, Paragonimus westermani 2024 ‫كلية الطب‬  Etiology  Food borne Parasitic infection  Infection comes after eating undercooked crab or crayfish that carry immature flukes  Cause a sub-acute to chronic inflammatory disease of the lung  Paragonimiasis can cause illness resembling Viral gastroenteritis or pneumonia. 2024 ‫كلية الطب‬  Geographic Distribution Paragonimiasis is common throughout the Americas, Africa and Asia… 2024 ‫كلية الطب‬  Morphology Adult  Typically reddish-brown and ovoid, measuring 7 to 16 mm by 4 to 8 mm, similar in size and.  convex dorsally concave ventrally  Appearance to a coffee bean  Hermaphroditic 2024 ‫كلية الطب‬  Morphology Egg  yellow-brown, ovoid or elongate  with a thick shell  At the large end, the operculum is clearly visible.  The eggs are unembryonated when passed in sputum or feces 2024 ‫كلية الطب‬  Life cycle 1. Unembryonated eggs are passed in the sputum of a human or feline 2. Two weeks later, miracidia develop in the egg and hatches 3. The miracidia penetrate its first intermediate host (snail) 4. Within the snail mother sporocyst form and produce many mother rediae 5. which subsequently produce many daughter rediae which shed crawling cercariae into freshwater 6. The crawling cercariae penetrate freshwater crabs and encyst in its muscles becoming metacercaria 7. Humans or felines then eat the infected crabs raw 8. Once eaten, the metacercaria excysts and penetrates the gut, diaphragm and lung where it becomes an adult worm in pairs 2024 ‫كلية الطب‬  Life cycle  Habitat: Adult worm live in respiratory tract (lung) of man.  Definitive Hosts:- Man and Domestic animals (zoonosis)  Intermediate Host:- First Host:- A fresh-water snail of the genus Melania Second Host:- A fresh-water crayfishes or crabs  Infective stage: Metacercaria  Mode of infection  Infection comes after eating undercooked crab or crayfish that carry immature flukes.  Contamination by Metacercaria during the process of cooking 2024 ‫كلية الطب‬  Clinical picture  When paragonimiasis symptoms do occur, they result from the worms’ location and activity in the body, which change over time.  Many people with paragonimiasis never experience any symptoms. 2024 ‫كلية الطب‬  Pathogenesis  Adult worms provoke granulomatous reactions ending by fibrotic encapsulation of the worms 2024 ‫كلية الطب‬  Pathogenesis  Aberrant migration of the immature worms may lead to Ectopic lesions in the abdomen, heart, brain…. 2024 ‫كلية الطب‬ Paragonimiasis Symptoms 1-In the first month or so after someone is infected, paragonimiasis worms spread through the abdomen, sometimes causing symptoms that can include:  Fever  Ill-feeling (malaise)  Diarrhea  Abdominal pain  Itching and hives 2024 ‫كلية الطب‬  Paragonimiasis Symptoms 2- Worms then travel from the abdomen into the chest. There they can cause respiratory symptoms, such as:  Cough … chronic  Shortness of breath  Chest pain (made worse by deep breathing or coughing) …Dyspnea The most common long-term paragonimiasis symptom is a cough with bloody sputum (hemoptysis) that comes and goes. Pleural effusion 2024 ‫كلية الطب‬  Paragonimiasis Diagnosis  Diagnosing paragonimiasis can be difficult or delayed. That's because its symptoms are often mild and overlap with more common conditions. Patient with symptoms has multiple tests before makes the diagnosis of paragonimiasis  Clinically  In Laboratory 2024 ‫كلية الطب‬  Paragonimiasis Diagnosis Adult after treatment Serology Early & chronic Nodular & Ring Radiology shadows 2024 ‫كلية الطب‬  Treatment The most common and effective drug to treat the lung infection : Praziquantel (Biltricide) three times daily for 3 days 2024 ‫كلية الطب‬  Prevention Control of the source of infection:  Treatment of cases  Avoid eating raw fresh water crabs and crayfishes.  Avoid sputum and stool getting into water.  Health education  Snail control 2024 ‫كلية الطب‬ Thank you