Paragonimoz

Paragonimoz - helminthiasis, usually affects the lungs, less brain. Exciter - Fluke Paragonimus westermani length of 7 -13 mm Infection paragonimoz occur by eating raw freshwater crabs and crayfish. For paragonimoz typical first enteritis, later - bronchitis, bronchial pneumonia, dry and exudative pleurisy. Possible pulmonary hemorrhage, purulent pleurisy, the introduction of worms or their eggs in the brain with the development of meningoencephalitis, syndrome tumors (headaches, seizures, mental disorders, sometimes paresis, and paralysis).
The diagnosis is made on clinical grounds, detection in sputum or Kale eggs of helminths.
Treatment of paragonimoz. Assign inside of bithionol in a daily dose: adults : 2-2,5 g; children under 5 years - 0.2 g; 5-8 years - 0.6 g; 9 - 12 years - 1 year; over 12 years, 1.5 - 2 g Daily dose given in three doses after meals. The course of treatment consists of taking 10
daily doses a day. Less effective 2% solution emetina, which is inserted under the skin in 1.5 ml, 2 times a day for 5-7 days; conduct such two-cycle interval of 7 days.
Prevention of paragonimoz. Protection of water bodies from pollution faeces. Eating crabs and crayfish only after careful provarivaniya.

Paragonimoz (paragonimosis) - bot, primarily affecting the lungs.
The disease is caused by the trematode Paragonimus westermani (synonym of P. ringeri) with a length of 7.5 to 13 mm, width of 4-8 mm Eggs brown, with lid, with a size of 0,08-DH X0,048-0,06 mm (Fig., 1). In the stage of puberty parasitizes in the lungs, less often in the brain and other organs, cat, tiger. The intermediate hosts shellfish Melania and others, additional hosts - freshwater crabs and crayfish.
Epidemiology. Patients paragonimoz humans and mammals is the source of invasion for shellfish; larvae that came from last, penetrate into crabs and crayfish. Man and mammals get paragonimoz when eating raw and not cooked crabs and crayfish. P. distributed mainly in China, Japan, the Korean Peninsula; registered in the USSR (the far East).
Pathology and pathogenesis. Larvae of paragonimus migrate through the wall of the small intestine into the abdominal cavity and, probada aperture and pleura, are introduced into the lungs (Fig., 2); sometimes they invade other organs. In the intestines, liver, spleen, the diaphragm, the pleura are detected bleeding, sometimes necrosis; in the lungs in an early phase of paragonimoz - hemorrhage, infiltrates, in late - cysts containing worms, cheesy mass, bloody or chocolate colored liquid. In the brain in the presence of helminthes are formed necrosis, adhesions between the shells, parasitic moves (Fig., 3).
Clinical course. Forms of paragonimoz: acute abdomen, acute pleuro-pulmonary, chronic lung complicated. Acute abdominal P. driven by the migration of young worms, accompanied by symptoms enteritis, hepatitis, aseptic peritonitis. In acute pleuro-pulmonary P. there fever, chest pain, cough, pneumonic lesions, sometimes dry or serous exudative pleurisy. In 2-3 months. this form P. becomes chronic lung with the change of exacerbations and remissions. The main symptoms: cough with blood, lung lesions dry and moist rales, in the period of exacerbation fever.
Radiographically distinguish infiltrative, cystic, alopecia, pneumosclerosis phase P.
Complications of paragonimoz - pulmonary hemorrhage, empyema, P. brain with symptoms meningoencephalitis, syndrome tumors.
The diagnosis is based on clinical and radiologic data, detection of eggs paragonimus in sputum and feces.
Forecast in the absence of complications satisfactory, with P. brain bad.
Treatment. When paragonimoz lung most effective bithionol - 2,2'- THIOBIS (4,6-diclorfenil), which is given orally in a daily dose: adults : 2-2,5 g; for children under 5 years - 0.2 g; 5 - 8 years - 0.6 g; 9-12 years - 1 year; 12 years and older is 1.5-2 g Daily dose given in three doses after meals. The course of treatment consists of assigning 10 daily doses a day. Less effective 2% solution emetina placed under the skin or muscle adults 1.5 ml, 2 times a day for 5-7 days; conduct such two-cycle every 7 days.
Prevention. You need to protect water from contamination by faeces; crabs and crayfish be eaten only after careful provarivaniya.

Paragonimus westermani (1) in the lungs (2) and in the human brain (3).