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Ectopic peritoneal paragonimiasis mimicking tuberculous peritonitis: A care report

Authors
  • 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
Type
Published Article
Journal
World Journal of Clinical Cases
Publisher
Baishideng Publishing Group Inc
Publication Date
Jun 06, 2022
Volume
10
Issue
16
Pages
5359–5364
Identifiers
DOI: 10.12998/wjcc.v10.i16.5359
PMID: 35812672
PMCID: PMC9210911
Source
PubMed Central
Keywords
Disciplines
  • Case Report
License
Unknown

Abstract

BACKGROUND The 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 SUMMARY A 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. CONCLUSION In 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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