Clinicoradiologic features of pleuropulmonary Paragonimus westermani on Kyusyu Island, Japan
Clinicoradiologic features of pleuropulmonary Paragonimus westermani on Kyusyu Island, Japan
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DOI：
10.1378/chest.120.2.514
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发表时间：
2001-08-01
期刊：
影响因子：
9.6
通讯作者：
Nawa, Y
中科院分区：
文献类型：
--
作者：
Mukae, H;Taniguchi, H;Nawa, Y
研究目标。近年来，人类感染卫氏并殖吸虫的新病例数逐渐增加，并成为日本九州重新出现的公共卫生问题。我们回顾了我们最近治疗胸肺肺并殖吸虫的经验。患者：1993年至1999年间，宫崎医学院内科第三科诊断出13例肺吸虫病。结果：9例患者中4例痰液及支气管镜检查均发现卵子；另外两名患者经支气管镜检查发现卵子。12例患者（92%）有呼吸道症状，包括咳嗽（92%）、咳痰和/或咯血（92%）和胸痛（46%）。胸片和CT显示胸膜病变（62%）和实质病变（92%）。值得注意的是孤立结节性病变的高频率（62%），类似肺癌、肺结核或真菌疾病。免疫诊断和支气管镜检查也有助于诊断。吡喹酮治疗非常有效，副作用最小。尽管使用吡喹酮治疗，1例患者仍需手术去皮。外周血和体液中可见嗜酸性粒细胞增多，这可能是由于白细胞介素-5水平升高所致。结论：我们的研究结果表明，我们的威氏并殖吸虫患者表现出各种各样的x线表现，与之前报道的经典表现不同。支气管镜检查和血清学检查对准确诊断非常有用。随着饮食习惯的改变和国际交通的增加，肺吸虫病在世界各地的发病率似乎也会增加。
Study objective. Recently, the number of new cases of Paragonimus westermani in humans has gradually increased, and paragonimiasis is a re-emerging public health issue in Kyusyu, Japan. We review our recent experience with pleuropulmonary Paragonimus westermani.Patients: Pulmonary paragonimiasis was diagnosed in 13 patients at the Third Department of Internal Medicine, Miyazaki Medical College between 1993 and 1999.Results: Both sputum and bronchoscopic examinations revealed ova in four of nine patients; bronchoscopy yielded ova in two additional patients. Twelve patients (92%) had respiratory symptoms, including cough (92%), sputum and/or hemoptysis (92%), and chest pain (46%). Chest radiography and CT showed pleural lesions (62%) and parenchymal lesions (92%). Of note was the high frequency of solitary nodular lesions (62%), mimicking lung cancer, tuberculosis, or fungal diseases. Immunodiagnosis and bronchoscopic examination were also useful for diagnosis. Praziquantel treatment was very effective and had minimal side effects. One patient required surgical decortication for empyema in spite of treatment with praziquantel. Eosinophilia was noted in peripheral blood and body fluids, which was probably due to increased levels of interleukin-5.Conclusion: Our findings indicate that our patients with Paragonimus westermani presented with a wide variety of radiographic findings, which were different from the classic presentations reported earlier. Bronchoscopic examination and serologic tests are very useful for accurate diagnosis. As dietary habits change and international transportation increases, it appears likely that paragonimiasis will also increase in frequency in various parts of the world.