Retrospective study of pleural parasitic infestations: a practical diagnostic approach

Autor: Weizhan Luo, Panxiao Shen, Jinlin Wang, Jianxing He, Yunxiang Zeng
Rok vydání: 2019
Předmět:
Male
0301 basic medicine
Chest Pain
Hemoptysis
medicine.medical_specialty
Paragonimus westermani
Fever
Pleural effusion
030106 microbiology
Chest pain
Gastroenterology
lcsh:Infectious and parasitic diseases
03 medical and health sciences
0302 clinical medicine
Carcinoembryonic antigen
Pleural parasitic infestation
Internal medicine
Taenia solium
Parasitic Diseases
medicine
Humans
Blood test
Eosinophilia
lcsh:RC109-216
030212 general & internal medicine
Leukocytosis
Aged
Retrospective Studies
Eosinophilic pleural effusion
medicine.diagnostic_test
biology
business.industry
Sputum
Middle Aged
medicine.disease
biology.organism_classification
Eosinophils
medicine.drug_formulation_ingredient
Infectious Diseases
Cough
Immunoglobulin G
biology.protein
Female
medicine.symptom
business
Research Article
Zdroj: BMC Infectious Diseases, Vol 19, Iss 1, Pp 1-7 (2019)
BMC Infectious Diseases
ISSN: 1471-2334
Popis: Background Pleural parasitic infestation (PPI) is a disease prevalent in certain parts of the world. It is frequently misdiagnosed due to its lack of standardized diagnostic criteria. The purpose of this study was to evaluate the clinical characteristics of PPI patients and develop a practical diagnostic approach for PPI. Methods A retrospective study was conducted by reviewing the medical records of 11 patients with PPI. A practical diagnostic approach was proposed based on the unique laboratory findings. Results All patients demonstrated respiratory symptoms, including shortness of breath, cough, fever, chest pain, excessive sputum and hemoptysis. Leukocytosis (> 10,000/μL) and eosinophilia (> 500/μL) of peripheral blood were present in 45.5 and 36.4% patients, respectively. The mean concentrations of pleural effusion lactate dehydrogenase (LDH), adenosine deaminase (ADA), protein and carcinoembryonic antigen (CEA) were 338.2 U/L (range, 61–667 U/L), 11.6 U/L (range, 0.1–28.2 U/L), 43.7 g/dL (range, 21.9–88.1 g/dL), and 1.84 mg/mL (range, 0.28–4.8 mg/mL), respectively. The mean percentage of eosinophils in the pleural effusion was 19.5% (10.5–41%). Blood test was positive for parasite-specific IgG antibody in 9 patients, including 4 for Paragonimus westermani, 3 for Taenia solium, 1 for Clonorchis sinensis and 1 for Echinococcus granulosus. Eggs of Clonorchis sinensis were detected in the stool of two patients. Sparganum was found in the pleural effusion of one patient. Respiratory symptoms and abnormal appearances in pulmonary radiographic examination were disappeared in all patients who received anti-parasitic treatment. Conclusions In patients with unexplained pleural effusion, parasite-specific IgG antibody tests should be performed when pleural fluid testing shows eosinophilic pleural effusion. It is preferable to consider the diagnosis of PPI in clinical practice when serum parasite-specific IgG antibody test is positive.
Databáze: OpenAIRE
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