View source for Paragonimus westermani

{{DISPLAYTITLE:''Paragonimus westermani''}}

== Background ==

* Also known as the oriental lung fluke
* Most common species of [[Genus::Paragonimus]] that infects humans

=== Epidemiology ===

* Distributed within southeast Asia and east Asia, including China, Korea, Japan, the Philippines, Taiwan, and India
** Other species are endemic to other parts of the world, including [[Paragonimus kellicotti]] in North America
* Primarily transmitted by consumption of raw or undercooked crab or crayfish
* Lifespan of a lung fluke is up to 20 years (if untreated)

== Clinical Manifestations ==

=== Pulmonary Paragonimiasis ===

* Acute phase: diarrhea, abdominal pain, fever, cough, urticaria, hepatosplenomegaly, pulmonary abnormalities, and eosinophilia
** As larvae penetrate the diaphragm, patients can have pleuritic chest pain and develop pneumothorax or pleural effusion (usual exudative and eosinophilic)
* Chronic phase: cough, sputum production, and hemoptysis
** May last for years

=== Extrapulmonary Paragonimiasis ===

* Immature flukes can migrate into brain, abdomen (including intestinal wall, liver, spleen, pancreas, kidney, adrenal gland, peritoneal cavity, ovary, mesenteric lymph nodes), and subcutaneous tissues
** Also, more rarely, to heart, mediastinum, muscle, spinal sord, parotid gland, testes, and breasts
* Eggs can deposite into ectopic sites as well, causing cyst, abscess, or granuloma formation

== Management ==

* First-line: [[praziquantel]] 75 mg/kg/day in three divided doses, for three days
* Second-line: [[triclabendazole]] 10 mg/kg p.o. once or twice

[[Category:Trematodes]]
[[Category:Respiratory infections]]