1/4. Just another hemoptysis or a fluke?Hemopytsis is commonly encountered in the daily practice of the pulmonary physician. Younger patients with normal chest x-rays frequently have acute or chronic bronchial disease accounting for their complaint. Occasionally parasitic disease is described as an unusual cause for a patient presenting with hemoptysis. Although pulmonary paragonimiasis is unusual in this country, because of the rapid growth in travel as well as immigration, physicians will need to be aware of this disorder.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/4. Pulmonary paragonimiasis in Laotian refugee children.Three Laotian refugee children with chronic pulmonary complaints and findings were found to have pulmonary paragonimiasis during a one-year period in chicago. These patients ranged from 8 to 11 years of age and the diagnosis was delayed five to six months in two children because of the unfamiliarity of American physicians with signs and symptoms of this disorder. Clinical manifestations included chronic cough for up to two years, apparent hemoptysis in two patients, lack of fever or sweats, and family history negative for tuberculosis. Physical findings included rales and dullness to percussion, clubbing (one patient), and lack of fever or respiratory distress. All three patients showed interstitial infiltrates on chest roentgenogram whereas two had multiple small cystic areas. Moderate eosinophilia was present. paragonimus westermani ova were found in stools of two patients, in sputum of two patients, and in bronchoscopic specimens in one patient. All patients demonstrated striking clinical and radiologic improvement following treatment with bithionol (50 mg/kg every other day for 15 doses), which was well tolerated. lung fluke infestation must be considered in Indochinese refugee children with apparent hemoptysis or chronic pulmonary symptoms, and sputum and stool should be examined for P westermani ova.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
3/4. paragonimiasis. Atypical appearances in two adolescent Asian refugees.paragonimiasis is a parasitic disease endemic to asia, africa, and south america. With the increasing number of Southeast Asian immigrants arriving in the united states, physicians should be aware of the various manifestations of this disease. We describe two adolescent Asian refugees who had atypical cases of paragonimiasis. One experienced acute abdominal pain mimicking appendicitis, and the other had asymptomatic left upper-lobe cavitation.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
4/4. Pleural paragonimiasis in a Southeast asia refugee.We report a Laotian patient with pleural paragonimiasis who did not have the usual diagnostic triad for this parasitic disease. He did not have chronic hemoptysis (considered by many to be an "invariable" finding), there were no pulmonary infiltrations, and stool and sputum examinations did not yield Paragonimus ova. The diagnosis was made on the basis of ova found in the pleural fluid. paragonimiasis pleural effusion did not resolve with bithionol, the drug of choice for pulmonary paragonimiasis, and, as a result, chest tube drainage was required. The difference between pleural paragonimiasis and pulmonary paragonimiasis is that the classic clinical presentation of the latter (hemoptysis, ova in sputum and stools, lung infiltration, etc.) requires an intrapulmonary location on the parasite. A search for ova in the pleural fluid may be the only diagnostic tool for patients suspected of pleural paragonimiasis. With the influx of Southeast asia refugees, this case report may be of relevance to U.S. physicians involved in the care of patients in whom not all chronic pleuropulmonary diseases are tuberculous.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |