| Clinical Study of Paragonimiasis |
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Jung Hee Lee1,2 |
1Department of Radiology, College of Medicine, Pusan National University
2Department of Internal Medicine, College of Medicine, Pusan National University |
| 폐흡충증의 임상적 연구 |
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이정희1,2 |
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| Abstract |
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This is a clinical study on 252 patients with paragonimiasis observed at Departments of Chest Medicine, General Medici ne, Neurology and Pediatrics of the National Medical Center, Seoul, Korea during 12 years of period dating from 1959 to 1970.
A distribution of the patients varies ranging from four to úxty-four years. 50% of the 252 patients are between in the second and the third decade. Male and female ratio is 1.7: 1. A history of ingestion of nlW crab is obtained in 24.2 percent of the patients. 10.2 percent has s history of raw cray fish ingestion , and the rest of them denies a history of ingestion in the past. In symptom analysis, rusty sputum is most common complaint, being in 71. 4 percent of the patients. The other symptoms include cough in 65.8%, fatigue in 26.5%, chest pain in 24.6, profuse sputum in 19.8 %, fever in 19.4%, headache in 19.4%, dyspnea in 19.0%, and fish smell from sputum in 11. 9%. Paragonimus westermani ova in repeated sputum test are demonstrated in 83% of the patients. Skin test for paragonimus westermani is noted two patients to be false negative, three doubtful, and the rest of them positive-Eosinophils in the peripheral blood is increased in number in 91. 5% of the patients-Slight to marked increase in gamma globulin is almost a constant finding (90.5% ). The albumin and globulin ratio is reversed in 23.9%. Slightly decreased alpha-1 globulin is present in 28.5 % of the patients. Among the ectopic localization of the disease, the brain is the most prevalent site constituting 37 cases. Encapsulated thoracic empyema is present in 9 cases. Pulmonary tuberculosis is combined with this disease in 29 cases (11. 5%). In the chest x-ray findíng s, no abnormality is noted in 10.2%. The rest show abnormal features with characteristic findings being cystic (34.0%) , patchy infiltration (47.5%) and pleural thickning (45. 8%). ln 43.1% of the lung lesions are located in both middle field s, in .34_ 7% in both lower field s and in 22.2% in both upper fields. The I" ight lung (53. 5%) is more frequently involved than the left (46. 5% ).
Bithionol has shown good effect in the treatment of Paragonimiasis in 108 cases. All cases has converted to be negative for presence of ova on sputum examination. By end of course of treatment, the improvement of clinical symptoms is noted but two cases relapsed on the sputum examination for eggs five month after the treatment. This two cases are converted to be negative by the second Course ot treatment. Of the side reactions, the most common symptom is frequent defecation with mild abdominal pain, being present in twelve cases. Five cases has urticaria, two cases mild fever, vomiting, dizziness each. These side reactions could not forced to stop the medication. Radiographic changes after the Bithionol therapy varied according to the initial x-ray features. The cystic and infiltrative changes disappeared within 2 to 3 months after the therapy, fibrotic infiltrative lesions ín 6 to 7 months, and the fibrotic nodular densities lasted more than 8 months. |
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