Intestinal paragonimiasis with colonic ulcer and hematochezia in an elderly Taiwanese woman

Korean J Parasitol. 2012 Dec;50(4):349-52. doi: 10.3347/kjp.2012.50.4.349. Epub 2012 Nov 26.

Abstract

A 94-year-old female with end-stage renal disease presents with fever, fatigue, and hematochezia. She had previously resided in Hunan Province, China, and Myanmar, and she immigrated to Taiwan 30 years ago. Colonoscopy revealed a colonic ulcer. Biopsy of the colonic ulcer showed ulceration of the colonic mucosa, and many Paragonimus westermani-like eggs were noted. Serum IgG antibody levels showed strong reactivity with P. westermani excretory-secretory antigens by ELISA. Intestinal paragonimiasis was thus diagnosed according to the morphology of the eggs and serologic finding. After treatment with praziquantel, hematochezia resolved. The present case illustrates the extreme manifestations encountered in severe intestinal paragonimiasis.

Keywords: Paragonimus westermani; colonic ulcer; ectopic; hematochezia; praziquantel.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Animals
  • Anthelmintics / therapeutic use
  • Antibodies, Helminth / blood
  • Antigens, Helminth / immunology
  • Colonic Diseases / complications
  • Colonic Diseases / drug therapy
  • Colonic Diseases / pathology*
  • Colonoscopy
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Gastrointestinal Hemorrhage / complications
  • Gastrointestinal Hemorrhage / drug therapy
  • Gastrointestinal Hemorrhage / pathology*
  • Humans
  • Intestinal Diseases, Parasitic / complications
  • Intestinal Diseases, Parasitic / drug therapy
  • Intestinal Diseases, Parasitic / parasitology
  • Intestinal Diseases, Parasitic / pathology*
  • Kidney Failure, Chronic / complications
  • Paragonimiasis / complications
  • Paragonimiasis / drug therapy
  • Paragonimiasis / parasitology
  • Paragonimiasis / pathology*
  • Paragonimus westermani / immunology*
  • Praziquantel / therapeutic use
  • Taiwan
  • Ulcer / complications
  • Ulcer / drug therapy
  • Ulcer / pathology*

Substances

  • Anthelmintics
  • Antibodies, Helminth
  • Antigens, Helminth
  • Praziquantel