Ectopic peritoneal paragonimiasis mimicking tuberculous peritonitis: A care report

BACKGROUNDThe most common site of paragonimiasis is in the lungs. The migratory route passes through the duodenal wall, peritoneum, and diaphragm to the lungs; thus, the thoracic cavity and central nervous system, as well as the liver, intestine, and abdominal cavity may be involved. Here, we presen...

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Veröffentlicht in:World journal of clinical cases 2022, Vol.10 (16), p.5359-5364
Hauptverfasser: Choi, Jung Woo, Lee, Chang Min, Kim, Seong Je, Hah, Se In, Kwak, Ji Yoon, Cho, Hyun Chin, Ha, Chang Yoon, Jung, Woon Tae, Lee, Ok Jae
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container_end_page 5364
container_issue 16
container_start_page 5359
container_title World journal of clinical cases
container_volume 10
creator Choi, Jung Woo
Lee, Chang Min
Kim, Seong Je
Hah, Se In
Kwak, Ji Yoon
Cho, Hyun Chin
Ha, Chang Yoon
Jung, Woon Tae
Lee, Ok Jae
description BACKGROUNDThe most common site of paragonimiasis is in the lungs. The migratory route passes through the duodenal wall, peritoneum, and diaphragm to the lungs; thus, the thoracic cavity and central nervous system, as well as the liver, intestine, and abdominal cavity may be involved. Here, we present a case of intraperitoneal paragonimiasis without other organ involvement, mimicking tuberculous peritonitis. CASE SUMMARYA 57-year-old man presented with recurrent abdominal pain for 4 wk. Physical examination revealed tenderness in the right lower quadrant. Laboratory findings showed complete blood counts within the normal range without eosinophilia. Multiple reactive lymph nodes and diffuse peritoneal infiltration were noted on abdominal computed tomography (CT). There were no abnormalities on chest CT or colonoscopy. Intraoperative findings of diagnostic laparoscopy for the differential diagnosis of tuberculous peritonitis and peritoneal carcinomatosis included multiple small whitish nodules and an abscess in the peritoneum. Pathological reports confirmed the presence of numerous eggs of Paragonimus westermani (P. westermani). A postoperative serum enzyme-linked immunosorbent assay revealed P. westermani positivity. Persistent and repetitive history-taking led him to retrospectively recall the consumption of freshwater crab. After 3 d of treatment with praziquantel (1800 mg; 25 mg/kg), he recovered from all symptoms. CONCLUSIONIn patients who require diagnostic laparoscopy for the differential diagnosis of tuberculous peritonitis and peritoneal carcinomatosis, repetitive history-taking and preoperative serologic antibody tests against Paragonimus may be helpful in diagnosing intraperitoneal paragonimiasis without other organ involvement.
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The migratory route passes through the duodenal wall, peritoneum, and diaphragm to the lungs; thus, the thoracic cavity and central nervous system, as well as the liver, intestine, and abdominal cavity may be involved. Here, we present a case of intraperitoneal paragonimiasis without other organ involvement, mimicking tuberculous peritonitis. CASE SUMMARYA 57-year-old man presented with recurrent abdominal pain for 4 wk. Physical examination revealed tenderness in the right lower quadrant. Laboratory findings showed complete blood counts within the normal range without eosinophilia. Multiple reactive lymph nodes and diffuse peritoneal infiltration were noted on abdominal computed tomography (CT). There were no abnormalities on chest CT or colonoscopy. Intraoperative findings of diagnostic laparoscopy for the differential diagnosis of tuberculous peritonitis and peritoneal carcinomatosis included multiple small whitish nodules and an abscess in the peritoneum. Pathological reports confirmed the presence of numerous eggs of Paragonimus westermani (P. westermani). A postoperative serum enzyme-linked immunosorbent assay revealed P. westermani positivity. Persistent and repetitive history-taking led him to retrospectively recall the consumption of freshwater crab. After 3 d of treatment with praziquantel (1800 mg; 25 mg/kg), he recovered from all symptoms. CONCLUSIONIn patients who require diagnostic laparoscopy for the differential diagnosis of tuberculous peritonitis and peritoneal carcinomatosis, repetitive history-taking and preoperative serologic antibody tests against Paragonimus may be helpful in diagnosing intraperitoneal paragonimiasis without other organ involvement.</description><identifier>ISSN: 2307-8960</identifier><identifier>EISSN: 2307-8960</identifier><identifier>DOI: 10.12998/wjcc.v10.i16.5359</identifier><language>eng</language><ispartof>World journal of clinical cases, 2022, Vol.10 (16), p.5359-5364</ispartof><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>780,784,4487,27923</link.rule.ids></links><search><creatorcontrib>Choi, Jung Woo</creatorcontrib><creatorcontrib>Lee, Chang Min</creatorcontrib><creatorcontrib>Kim, Seong Je</creatorcontrib><creatorcontrib>Hah, Se In</creatorcontrib><creatorcontrib>Kwak, Ji Yoon</creatorcontrib><creatorcontrib>Cho, Hyun Chin</creatorcontrib><creatorcontrib>Ha, Chang Yoon</creatorcontrib><creatorcontrib>Jung, Woon Tae</creatorcontrib><creatorcontrib>Lee, Ok Jae</creatorcontrib><title>Ectopic peritoneal paragonimiasis mimicking tuberculous peritonitis: A care report</title><title>World journal of clinical cases</title><description>BACKGROUNDThe most common site of paragonimiasis is in the lungs. The migratory route passes through the duodenal wall, peritoneum, and diaphragm to the lungs; thus, the thoracic cavity and central nervous system, as well as the liver, intestine, and abdominal cavity may be involved. Here, we present a case of intraperitoneal paragonimiasis without other organ involvement, mimicking tuberculous peritonitis. CASE SUMMARYA 57-year-old man presented with recurrent abdominal pain for 4 wk. Physical examination revealed tenderness in the right lower quadrant. Laboratory findings showed complete blood counts within the normal range without eosinophilia. Multiple reactive lymph nodes and diffuse peritoneal infiltration were noted on abdominal computed tomography (CT). There were no abnormalities on chest CT or colonoscopy. Intraoperative findings of diagnostic laparoscopy for the differential diagnosis of tuberculous peritonitis and peritoneal carcinomatosis included multiple small whitish nodules and an abscess in the peritoneum. Pathological reports confirmed the presence of numerous eggs of Paragonimus westermani (P. westermani). A postoperative serum enzyme-linked immunosorbent assay revealed P. westermani positivity. Persistent and repetitive history-taking led him to retrospectively recall the consumption of freshwater crab. After 3 d of treatment with praziquantel (1800 mg; 25 mg/kg), he recovered from all symptoms. 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title Ectopic peritoneal paragonimiasis mimicking tuberculous peritonitis: A care report
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