PULMONARY PARAGONIMIASIS IN A PATIENT WITH INTRACEREBRAL HEMORRHAGE: A CASE REPORT FROM HANOI MEDICAL UNIVERSITY HOSPITAL

Pham Ngoc Minh1,2, Do Trung Dung1,2, Nguyen Ngoc Bich1,2, Cao Van Huyen1,2, Pham Ngoc Duan1,2, Pham Thi Bich Ngoc1,2, Nguyen Thi Hue1,2, Tran Kim Lam1,2, Do Thai Son1, Hoang Thi Phuong Thanh2,3
1 Hanoi Medical University
2 Hanoi Medical University Hospital
3 . Hanoi Medical University

Main Article Content

Abstract

This report describes a clinical case of a patient admitted with intracerebral hemorrhage secondary to hypertension, with a significant 10-year history of chronic hemoptysis. The patient had been repeatedly misdiagnosed with chronic bronchitis or pneumonia at multiple healthcare facilities. During hospitalization, the clinical course became exceptionally complex, involving a series of medical complications. A definitive diagnosis of pulmonary paragonimiasis was established on the 7th day of admission following the recovery of Paragonimus eggs from both endotracheal aspirates and stool samples, complemented by a positive ELISA serology. Radiological findings from chest X-ray and CT scans revealed characteristic lesions of paragonimiasis, which were managed with a specific regimen of praziquantel in conjunction with intensive supportive care. After more than one month of treatment, parasitological clearance was achieved, and the patient was stabilized and subsequently discharged. This case study aims to provide valuable clinical insights into the diagnostic considerations, therapeutic strategies, and prognostic implications of paragonimiasis, particularly in patients presenting with chronic hemoptysis where complex underlying comorbidities may mask parasitic symptoms.

Article Details

References

[1]. Epidemiology, pathology and treatment of paragonimiasis in Vietnam. ResearchGate. https://www.researchgate.net/publication/287756408_Epidemiology_pathology_and_treatment_of_paragonimiasis_in_Vietnam
[2]. Doanh PN, Dung DT, Thach DTC, Horii Y, Shinohara A, Nawa Y. Human paragonimiasis in Viet Nam: Epidemiological survey and identification of the responsible species by DNA sequencing of eggs in patients’ sputum. Parasitology International. 2011 Dec 1;60(4):534–7.
[3]. Phạm Ngọc Minh. Ký sinh trùng y học (sau đại học) - Tập 2. 2023. p. 291–312.
[4]. Doanh PN, Horii Y, Nawa Y. Paragonimus and Paragonimiasis in Vietnam: an Update. Korean J Parasitol. 2013 Dec;51(6):621–7.
[5]. thuvienphapluat.vn. Quyết định 1573/QĐ-BYT 2022 hướng dẫn chẩn đoán điều trị sán lá phổi. Available from: https://thuvienphapluat.vn/van-ban/The-thao-Y-te/Quyet-dinh-1573-QD-BYT-2022-huong-dan-chan-doan-dieu-tri-san-la-phoi-518133.aspx
[6]. Cho SY, Kim SI, Kang SY, Kong Y, Han SK, Shim YS, et al. Antibody changes in paragonimiasis patients after praziquantel treatment as observed by ELISA and immunoblot. Kisaengchunghak Chapchi. 1989 Mar;27(1):15–21.
[7]. Putra AC, Chyntia B, Winardi E, Johan M, Pradwiyanto AA, Tambun R, et al. Primary pulmonary amoebiasis mimicking lung tumour in immunocompromised patient: A case report. Respirology Case Reports. 2023;11(8):e01199.
[8]. Hwang KE, Song HY, Jung JW, Oh SJ, Yoon KH, Park DS, et al. Pleural fluid characteristics of pleuropulmonary paragonimiasis masquerading as pleural tuberculosis. Korean J Intern Med. 2015 Jan;30(1):56–61.
[9]. Shah P, Sah R, Pradhan S, Bhandari P, Baral R, Khanal B, et al. Pulmonary Paragonimiasis: A Case Series. JNMA J Nepal Med Assoc. 2023 Mar;61(259):290–3.
[10]. Im JG, Whang HY, Kim WS, Han MC, Shim YS, Cho SY. Pleuropulmonary paragonimiasis: radiologic findings in 71 patients. AJR Am J Roentgenol. 1992 July;159(1):39–43.