Paragonimiasis

paragonimiasis, infection caused by parasitic trematodes of the genus Paragonimus. Infection most commonly is with the lung fluke Paragonimus westermani, which may reach some 8 to 12 mm (0.3 to 0.5 inch) in length. Paragonimiasis caused by P. westermani is especially common in East Asia, particularly in Japan. Infections involving other Paragonimus species are known to occur in parts of Africa and the Americas.

Paragonimus worms live in the lungs of the infected individual, where they produce small cysts with fibrous walls. When a cyst in the lung ruptures, the eggs of the worm are coughed up in the sputum, some of which is swallowed, so that the eggs are passed in the feces. Finding their way to water, the eggs hatch into larvae, which then infect freshwater snails. When the larvae emerge from the snails, they enter and infect freshwater crabs and crayfish.

Humans acquire the infection by eating undercooked crab or crayfish harbouring the fluke larvae. The pulmonary lesions and symptoms resemble those of tuberculosis in many respects. Definitive diagnosis is obtained by finding the fluke eggs in the sputum, which may be bloodstained and purulent. In heavy infestations, lesions may also be found in the liver, skeletal muscle, and brain.

Treatment usually is with either praziquantel or bithionol. In the absence of reinfection, gradual recovery takes place after the worms die. Prevention consists of the thorough cooking of shellfish.