Abstract:

To analyze the epidemiology and clinical characteristics of paragonimiasis in Jiangxi Province in recent ten years. The epidemiological and clinical data of patients with paragonimiasis who were diagnosed and treated at Jiangxi Institute of Parasitic Diseases from May 2011 to December 2020 were collected and analyzed retrospectively. A total of 41 patients’ data were collected. The average age of the 41 patients was (29.69 ± 19.94) years. Patients aged between 18-59 accounted for 51.2% (21/41). Out of all the patients, 29 cases were males, and 12 were females. The course of the disease lasts 10 days to 5 years. The patients were from 8 districts and cities in Jiangxi Province, of which Yichun had the most cases, accounting for 43.9% (18/41). Before the onset of the disease, 48.8%(20/41) of the patients drank stream water, 31.7% (13/41) ate raw/half raw shrimps and crabs, 9.7%(4/41) caught or played with crabs, 9.7% (4/41) had no clear history of eating raw or semi-raw food. The positive rate of serum anti-Paragonimus antibodies was 100%. The mixed type accounted for 39.0% (16/41), thoracopulmonary type accounted for 26.8% (11/41), subcutaneous type for 14.6% (6/41), abdominal and hepatic type for 12.1% (5/41), cerebral type for 7.3%(3/41). The eosinophils count was increased in 41 patients, the highest was 17.74 × 10⁹/L, and the highest percentage of eosinophils was 76.34%; 21 patients (51.2%) had significantly increased peripheral blood leukocyte count, the highest was 44.10 × 10⁹/L. The paragonimiasis serum IgG antibodies of the patients were all positive and had cross-reaction with various parasites, among which the positive crossover rate with serum schistosomiasis antibody was 58.5%(24/41). Computed tomography (CT) results showed that 22 cases of chest bilateral or unilateral pleural effusion of varying degrees, 5 cases of local encapsulated effusion, and 3 cases of pericardial effusion; chest CT scan results showed that 9 cases of intrapulmonary scattered patchy and nodular increased density shadows, 10 cases of tunnel sign, and 1 patient had atelectasis. Magnetic resonance imaging (MRI) showed that 6 patients with cerebral paragonimiasis had hemorrhagic foci, circular, quasi- circular cystic, multiple nodules, with aggregation, migration-like lesions and tunnel-like changes. Susceptibility-weighted imaging (SWI) showed multiple short-track-like low-intensity shadows and round-like low-intensity shadows in the brain. Three patients underwent fine-needle aspiration cytology examination of subcutaneous mass. Lymphocytes, eosinophils and fusiform bamboo leaf-shaped Charcot-Ryden crystals were found under wright staining microscopy. Eggs or parasites of Paragonimus were not found in all 41 patients by pathogenic examination. 41 patients were all cured after more than one course of treatment. The prevalence of paragonimiasis in Jiangxi Province was sporadic. Paragonimiasis should be diagnosed with a comprehensive analysis of the epidemiological history, serum antibody testing, imaging examination, eosinophilia, etc. A good prognosis is expected after praziquantel treatment.

Key words: Paragonimiasis, Case analysis, Epidemiology, Clinical feature