Articles: parasitic-lung-diseases.
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Review Case Reports
Human paragonimiasis in North America following ingestion of raw crayfish.
Paragonimiasis (human infections with the lung fluke Paragonimus westermani) is an important public health problem in parts of Southeast Asia and China. Paragonamiasis has rarely been reported from North America as a zoonosis caused by Paragonimus kellicotti. Paragonimus species have complex life cycles that require 2 intermediate hosts, namely, snails and crustaceans (ie, crabs or crayfish). ⋯ These patients acquired their infections after consuming raw crayfish from rivers in Missouri. It is likely that other patients with paragonimiasis have been misdiagnosed and improperly treated. Physicians should consider the possibility that patients who present with cough, fever, hemoptysis, and eosinophilia may have paragonimiasis.
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In patients with abnormalities of cell-mediated immunity, strongyloides hyperinfection syndrome may occur producing pulmonary infection that may manifest as asthma, chronic bronchitis, haemoptysis, eosinophilia and pulmonary infiltrates. We report a case of an uncontrolled asthma patient who presented with fever and haemoptysis. She had no evidence of immunosuppression and CT chest showed a lesion suspicious of malignancy, sputum cytology showed strongyloides larvae and the patient had complete recovery with treatment.
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A 48-year-old man with a 75-pack-year history of tobacco use was referred to pulmonary clinic for evaluation of an abnormal chest roentgenograph. He had been followed by his primary physician for bronchitis and nonproductive cough over the past year and was recently treated with a course of antibiotics with no change in symptoms. He had no other medical history, was currently smoking two packs of cigarettes per day, and reported working on the docks in a shipyard for five years. On physical examination, he was afebrile with stable vital signs and 97% oxygen saturation on room air. He was well-developed in no apparent distress. On cardiovascular examination, he was in sinus rhythm without murmurs. Chest examination was clear to auscultation. There was no lymphadenopathy. The abdomen was soft and benign. The extremities were without clubbing, cyanosis, or edema. The rest of the physical examination was unremarkable. ⋯ The patient had a chest computed tomography (CT) available for review (Fig. 2). What diagnostic study should be performed next?