Paragonimiasis Diagnosis continued...
Most often, a person with symptoms has multiple tests before a doctor makes the diagnosis of paragonimiasis. Exams and tests used to make a diagnosis include:
Patient History. Your doctor will get clues about possible paragonimiasis by looking at the pattern in which your symptoms appeared. Your doctor will ask about your past eating of undercooked crab or crayfish.
Physical examination. Abnormal breath sounds or belly tenderness observed with a doctor’s examination of the chest or belly can suggest a problem and direct further testing.
Blood tests. A high number of a specific type of white blood cells can suggest parasitic infection. Antibodies against flukes may be present in the blood.
Sputum microscopy. Fluke eggs can be detected during examination of coughed-up sputum under a microscope.
Chest X-ray. Nodules (spots) in the lungs, hollowed-out areas (cysts or cavities), or fluid around the lungs (pleural effusions) may be present.
CT scan. High-resolution images of the lungs may show more detailed information than a chest X-ray. Also, CT of the head or abdomen may be abnormal if paragonimiasis involves the brain or liver.
MRI. Very high-definition images of the brain can identify cysts or brain swelling caused by paragonimiasis.
Bronchoscopy. A doctor can put an endoscope (flexible tube with a camera on its tip) through the nose or mouth into the lungs. Flukes or their eggs are collected from lung fluid samples. The flukes or eggs may be seen under a microscope.
Thoracentesis. A doctor puts a needle through the chest wall to sample fluid around the lungs (pleural effusion).
Stool studies. Fluke eggs may be seen in stool samples when examined under a microscope.
A definite diagnosis of paragonimiasis is made when fluke eggs are detected in an infected person’s sputum or stool. But the flukes may not lay eggs until two months after you are infected. That makes early diagnosis difficult.
In most people, paragonimiasis can be cured with oral anti-parasite medications. The recommended treatment is praziquantel (Biltricide). It is taken three times daily for three days.
In the rare cases of paragonimiasis with brain involvement, other treatments may be necessary, such as anti-seizure medications or surgery to reduce brain swelling.