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KMID : 0425120170550030313
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Parasites, Hosts and Diseases
2017 Volume.55 No. 3 p.313 ~ p.317
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A Case of Ectopic Peritoneal Paragonimiasis Mimicking Diverticulitis or Abdominal Abscess
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Kim Min-Jae
Kim Sung-Han
Lee Sang-Oh
Choi Sang-Ho
Kim Yang-Soo
Woo Jun-Hee
Yoon Yong-Sik
Kim Kyung-Won
Cho Jae-Eun
Chai Jong-Yil
Chong Yong-Pil
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Abstract
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Paragonimiasis is a parasitic disease caused by Paragnonimus species. The primary site of infection is the lung, and extrapulmonary involvement is also reported. When infected with Paragonimus westermani, which is the dominant species in Korea, the central nervous system is frequently involved along with the liver, intestine, peritoneal cavity, retroperitoneum, and abdominal wall. Ectopic paragonimiasis raises diagnostic challenge since it is uncommon and may be confused with malignancy or other inflammatory diseases. Here, we report an ectopic paragonimiasis case initially presented with recurrent abdominal pain. The patient developed abdominal pain 3 times for the previous 3 years and the computed tomography (CT) of the abdomen revealed fluid collection with wall enhancement. Recurrent diverticulitis was initially suspected and part of the ascending colon was resected. However, the specimen showed intact colon wall without evidence of diverticulitis and multiple parasite eggs and granulomas were found instead. The size of about 70 μm, the presence of an operculum and relatively thick egg shell suggested eggs of Paragonimus species. With appropriate exposure history and a positive antibody test, the definitive diagnosis was made as peritoneal paragonimiasis.
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KEYWORD
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Paragonimus westermani, paragonimiasis, peritoneaum, abscess, parasite egg
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