Massive secretions in paragonimiasis pleural effusion: a new finding concerning clinical recognition and treatment

作者全名："Zhang, Yunxuan; Xie, Yimin; Luo, Yarui; Xiang, Shuang; Zhong, Wen; Wu, Na; Chen, Meng; Zhou, Xiaojiao; Peng, Shulei; Chen, Qiang"

作者地址："[Zhang, Yunxuan; Xie, Yimin; Luo, Yarui; Wu, Na; Chen, Meng; Chen, Qiang] Chongqing Univ, Dept Pediat Surg, Gorges Hosp 3, Chongqing 404000, Peoples R China; [Zhang, Yunxuan] Chongqing Med Univ, Dept Burn & Plast Surg, Childrens Hosp, Chongqing 400014, Peoples R China; [Xiang, Shuang] Chongqing Univ, Dept Pathol, Gorges Hosp 3, Chongqing 404000, Peoples R China; [Zhong, Wen] Chongqing Univ, Dept Med Imaging, Gorges Hosp 3, Chongqing 404000, Peoples R China; [Zhou, Xiaojiao] Chongqing Univ, Dept Ultrasonog, Gorges Hosp 3, Chongqing 404000, Peoples R China; [Peng, Shulei] Chongqing Univ, Dept Sleep Med Ctr, Gorges Hosp 3, Chongqing 404000, Peoples R China"

通信作者："Chen, Q (通讯作者)，Chongqing Univ, Dept Pediat Surg, Gorges Hosp 3, Chongqing 404000, Peoples R China.; Peng, SL (通讯作者)，Chongqing Univ, Dept Sleep Med Ctr, Gorges Hosp 3, Chongqing 404000, Peoples R China."

来源：EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES

ESI学科分类：MICROBIOLOGY

WOS号：WOS:000939337500001

JCR分区：Q2

影响因子：3.7

年份：2023

卷号：42

期号：4

开始页：493

结束页：501

文献类型：Article

关键词：Paragonimiasis; Lung fluke disease; Secretions; Clinical recognition; Treatment; Species variations

摘要："Some paragonimiasis patients in Chongqing, southwest China, have recently exhibited pleural effusions (PEs) with massive viscous secretions. This study aimed to investigate their clinical characteristics, thereby promoting effective treatments. A 3-year retrospective review of paragonimiasis patients who were admitted for nonhomogeneous PEs at Chongqing University Three Gorges Hospital was conducted. Epidemiological data, symptoms, laboratory and imaging findings, treatments, and outcomes were analyzed. Twenty-eight patients were identified, of which 22 (78.6%) were males and 22 (78.6%) were rural residents. Respiratory (85.7%) and constitutional (57.1%) symptoms were common. Paragonimus-specific ELISA was positive in all patients. Eosinophilia was detected in all patients in peripheral blood and PEs. Irregular hyperdense signals were observed in PEs by chest CT scans (96.4%) and ultrasonography (100.0%). Thoracic closed drainage failed in 10 patients (conservative group) because of tube blockage and was eventually replaced by video-assisted thoracoscopic surgery (VATS). Eighteen patients (surgery group) initially underwent VATS, or thoracotomy surgery, without complications. Massive secretions, described as ""bean-dregs"" or ""egg-floccule,"" were detected intraoperatively, which explained the imaging findings and tube blockage. All patients recovered well after 2-3 courses of postoperative praziquantel treatment. Viscous secretions in paragonimiasis patients warrant great concern. Irregular hyperdense signals in effusions are important characteristics in CT scans and ultrasonography. Treatments such as thoracic closed drainage may fail due to viscous secretions blocking the tube; therefore, surgeries should be considered. In-depth multidisciplinary research may help determine the optimal treatment strategy and reveal the origin of these secretions."

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