Paragonimus

Background

• Species of trematode
• Also known as lung flukes
• Multiple species can infect humans, with different geographic distributions

Species	Geographic Distribution	Notes
Paragonimus westermani	China, Korea, Japan, the Philippines, Taiwan, and India	By far the most common cause of disease in humans
Paragonimus heterotremus	Thailand, as well as India, southern China, and Vietnam
Paragonimus skrjabini	Japan and China	Extrapulmonary disease more likely than with other species
Paragonimus africanus and Paragonimus uterobilateralis	Africa, particularly the rainforests of West and Central Africa
Paragonimus mexicanus	Central and South America
Paragonimus kellicotti	United States and Canada

Diagnosis

• Microscopy for eggs in sputum
• Eggs occasionally found in stool

Treatment

• Praziquantel 25 mg/kg p.o. three times daily for 6 doses
  • For cerebral disease, may need a short course of corticosteroids as well
• Second-line is triclabendazole 10 mg/kg q12h for 2 doses