Diagnosis and surgical management of pericardial effusion due to paragonimiasis

• Published in: International journal of infectious diseases Vol. 83; pp. 102 - 108
• Main Authors: Wu, Yuhao, Zhou, Yuehang, Jin, Xin, Li, Yonggang, Li, Hongbo, Dai, Jiangtao, Wang, Gang, Wu, Chun
• Format: Journal Article
• Language: English
• Published: Canada Elsevier Ltd 01.06.2019; Elsevier
• Subjects: Children; Diagnosis; Paragonimiasis; Pericardial effusion; Surgery; Children; Diagnosis; Surgery; Paragonimiasis; Pericardial effusion
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2019.03.032

•Typical endemic history, eosinophilia and multiple serous effusions indicate the diagnosis of paragonimiasis.•The clinical outcomes of patients with pericardial effusion were satisfactory after surgical intervention and overall 3 to 4 courses of praziquantel therapy.•Unlike the other paragonimus species (ie. P. westermani), it is difficult to find eggs in P. skrjabini infected humans, as humans are not the normal definitive host. The diagnosis of P. skrjabini infection is confirmed by the serologic test and biopsy. The pericardial effusion (PE) caused by paragonimiasis is rarely reported. This study aims to present experience in the diagnosis and surgical management of PE due to paragonimiasis. Medical records of 57 children who were diagnosed with PE due to paragonimiasis and underwent surgery at Children’s Hospital of Chongqing Medical University between January 2012 and August 2018 were retrospectively reviewed. The average age of this group was 7.6 ± 3.0 years. Patients were mainly from Chongqing and Sichuan areas. ELISA for Paragonimus skrjabini in all 57 patients showed positive results. Moderate or large PE were identified in 12 and 45 patients, respectively. All patients underwent surgery either by pericardectomy or thoracoscopic surgery. Pathological exams indicated massive eosinophil infiltration in all 57 specimens. After 3–4 courses of praziquantel therapy, the clinical outcomes were satisfactory. Typical endemic history, eosinophilia and multiple serous effusion raise suspicions of paragonimiasis. Once moderate to large PE is identified in patients with paragonimiasis, surgical treatment is necessary.