This document provides an overview of paragonimiasis, a parasitic infection of the respiratory tract caused by the trematode Paragonimus westermani. It is endemic in northeast India, especially Manipur. The life cycle involves 3 hosts - humans, snails, and crabs or crayfish. Clinical manifestations include cough with rusty sputum due to lung cysts and inflammation. Diagnosis is made by detecting eggs in sputum or antibodies/antigens in serum or stool. Prevention focuses on sanitation and health education. Treatment uses praziquantel.

1. PARAGONIMIASIS
BY
ELAMUHILAN.P.C
2ND YEAR MBBS

2. OBJECTIVES
• INTRODUCTION
• EPIDEMIOLOGY
• MORPHOLOGY
• LIFE CYCLE
• PATHOGENESIS AND CLINICAL MANIFESTATION
• LABORATORY DIAGNOSIS
• PREVENTION
• TREATMENT

3. INTRODUCTION
• Parasitic infection of respiratory tract
• Causative organism: paragonimus westermani
• Trematode
• Oriental lung fluke
• Causes ENDEMIC HEMOPTYSIS (blood in sputum) in Man

4. EPIDEMIOLOGY
• It is endemic in Northeast states of India
• Many cases are reported from MANIPUR with a prevalence of 6.7%

5. MORPHOLOGY
• Trematode ,has 3 forms;
• Adult worm (leaf like)
• operculated eggs
• larvae (5 stages)

6. ADULT WORM EGG

7. LIFE CYCLE
• Lung fluke has 3 hosts
• 1 Definitive host , 2 Intermediate host
• Definitive host ; HUMANS
• 1st Intermediate host ; SNAILS
• 2nd Intermediate host ; CRABS and CRAYFISHES
• Infective form : METACERCARIA LARVAE
• Transmission through contaminated food

9. PATHOGENESIS AND CLINICAL MANIFESTATION
• Due to multiplication of adult worms in lungs
• PULMONARY PARAGONIMIASIS (endemic hemoptysis)
• causes eoisinophilic granulomatous
inflammation in the lungs and forms cyst surrounding the worms
• Common presenting feature ; cough with brownish blood tinged
rusty sputum with an offensive fishy odor
• In chronic cases BRONCHITIS,BRONCHIECTASIS,PNEUMONIA OR
LUNG ABSCESS

10. • EXTRAPULMONARY PARAGONIMIASIS;
• Worms migrate from ruptured cyst to various sites
such as Liver,spleen,abdominal wall and less common in brain
• Extrapulmonary infections are usually associated with
P.heterotremus,P.mexicanus,etc.
• CEREBRAL PARAGONIMIASIS
• CUTANEOUS PARAGONIMIASIS

11. LABORATARY DIAGNOSIS
• SPUTUM MICROSCOPY
• Sample; early morning ,deeply coughed sputum
• examined for operculated eggs
• sputum can be concentrated by FORMALIN-ETHER
sedimentation technique
• In children,stool microscopy is done

12. • SEROLOGICAL TESTS
• Antibody detection by
• DIGFA
• ELISA
• WESTERN BLOT
• Antigen detection by
• Dot ELISA format by using monoclonal antibodies
• RADIOLOGICAL TESTS : CT,MRI,X-RAY

13. PREVENTION
• Sanitary disposal of sputum
• Control of snails
• Treatment of cases
• Health education

14. TREATMENT
• PRAZIQUANTEL (25mg/kg/dose) TDS * 2days, is the drug of choice
for paragonimiasis

15. NANDRI VANAKKAM!!!