Definition

The fluke of the lung or pulmonary distomatose also called paragonimiasis, Paragonimiose and endemic hemoptysis is due to infection by a nematode genus Paragonimus. The disease is characterized by the occurrence of hémoptysies resembling those of tuberculosis.

Classification

Different species of Paragonimus likely to cause the lung distomatose are:

• Paragonimus szechuananensis in China
• Paragonimus westermanni in Asia
• Paragonimus Africanus in Africa
• Paragonimus Mexicanus in South America

The pulmonary distomatose is the result of a parasitic by a trematode length 15 mm eggs are deposited in the Interior of lung tissue infested by cysts from adult worms.The next step is characterized by the Elimination of eggs through sputum or stool, once their made swallowing (after the patient had ingested eggs).From the egg emerges a miracidium in water whose sole purpose is to find a mollusc to live. The mollusk is the first intermediate host in this case.The term miracidium (from the Greek meirax: young man, English miracidium is the embryo which has some mobility and from the egg of Schistosoma.) The miracidium aims to infest an intermediate host (formed by a freshwater mollusc) and has to transform into multiple cercariae which a fpois released by the mollusc infested, penetrate into the host final that is human.Then there is the release of cercaria which will be released to turn in the water to go set on a crustacean. It can be the crayfish or a crab then constituting the second intermediate host again.It is the ingestion of this crustacean by an animal see a man that ends the parasitic cycle. In this case it is the definitive host (dog, cat, pig, wild animal).Inside the intestine of the definitive host there is the release of metacercariae which pass through the intestinal wall into the peritoneal cavity.A metacercaria (from the Greek métâ: change and kerkos: tail, English metacercaria) is a form of the cercaria inscrutable. The cercaria is a trematode in the final stage in the State of larva. The cercaria is mobile with a tail that allows him to leave its intermediate host i.e. a mollusc and then turn into a cyst on the surface of a plant inside the water.Pulmonary infestation is due to the passage of the parasite of the peritoneal cavity into the lungs through the diaphragm.Precisely within the lungs the parasite lodges in the bronchi and bronchioles.

Symptoms

Incubation extends between 2 to 3 days and 20 days.The patients lung fluke-infested are:

• A cough
• Respiratory difficulties to type of Dyspnea
• Low-grade (fever close)
• Hémoptysies (red blood from the respiratory tract sputum) abdominal pain accompanied by frequent diarrhea.

Outside this history (symptoms that the patient) classic individuals, due to a localization brain (in the brain), are likely to make seizures and present other neurological signs.Rarely there is an infringement of prostate (of the prostate) and epididymal (of the epididymis).The prostate is a gland of the male genital apparatus located under the bladder and the first part of the urethra. Its physiological role is the secretion of a substance forming one of the elements of the sperm.The epididymis is a hair elongated body of prior back the top edge of the testis.  

Medical analysis

Laboratory tests to highlight, from the fourth month, eggs in stool or sputum containing blood.Blood tests and more particularly the formula count (number of white blood cells, red blood cells and platelets) show a blood hyperéosinophilie corresponding to a rise in the rate of eosinophils (white blood cells variety increasing in the presence of parasitosis).More recently, serology is the diagnosis with certainty.

Medical examination

The x-ray lungs first shows a few blurry opacities are dotted with vacuoles.Later these opacities are densifient and are calcified sometimes. At this stage they are likely to be confused with images of pulmonary tuberculosis.

Treatment

Lung distomatose treatment involves two drugs:

• Triclabendazole administered 20 mg per kilogram of weight.
• Praziquantel which is ordered 25 mg / kg three times a day for two days.

Prevention

Prophylaxis of pulmonary distomatose in endemic countries is obtained by avoiding eating Freshwater crustaceans.