The affected person: A 32-year-old lady in Shanghai
The signs: The girl went to the hospital with a persistent cough accompanied by occasional bloody phlegm, which she would cough up two to 3 occasions per day. She mentioned the coughing started 4 months previous to her hospital go to. And a couple of month earlier than the coughing began, she had a fever that lasted a number of weeks and reached as much as 100.8 levels Fahrenheit (38.3 levels Celsius).
The affected person’s docs gave her steroids to scale back the irritation in her lung tissue. Nonetheless, her cough continued even after two months of this therapy. A CT scan of her lungs revealed recurring lesions, or tissue accidents, and she or he was then despatched to a unique hospital for additional examination.
The prognosis: When docs on the second hospital reviewed the girl’s medical historical past, they famous that her weight loss plan typically included uncooked seafood, and she or he additionally reported “a desire for uncooked frogs and bullfrogs,” the physicians wrote in a report describing her case. The group performed a blood check to see if her blood contained antibodies to any parasites, and so they discovered antibodies for the larvae of Spirometra mansoni, a sort of tapeworm.
The larvae, or spargana, of S. mansoni trigger a parasitic an infection referred to as sparganosis. This an infection is most typical in japanese Asia, and other people typically purchase the parasites by consuming uncooked or undercooked snakes or frogs which are contaminated with the larvae, proof suggests. After S. mansoni larvae are swallowed, they migrate into varied physique tissues and organs. Within the lady’s case, they gathered in her lungs — a really uncommon vacation spot for the parasite.
When the affected person supplied docs with a frog from her area of Shanghai, they dissected it and located that it was carrying S. mansoni.
As a result of the girl’s signs and the outcomes of her CT scans intently resembled indicators of eosinophilic pneumonia, the physicians who examined her throughout her first hospital go to misdiagnosed her, in response to the report.
The therapy: Medical doctors handled the girl with praziquantel tablets, a drug that works in opposition to varied sorts of parasitic worms. After the girl had taken the tablets for 5 days, her coughing subsided.
CT scans carried out 20 days after her admission to the second hospital confirmed that the shadowy areas beforehand seen in her lungs — an indication of an infection or bodily trauma — have been shrinking. At a follow-up go to one month later, her coughing was utterly gone. Nonetheless, the affected person’s blood checks confirmed that she was nonetheless producing antibodies in opposition to the parasite, hinting that the an infection continued.
Medical doctors prescribed one other five-day course of praziquantel and performed a follow-up examination 5 months after that. Traces of antibodies remained within the affected person’s blood, however solely in extraordinarily low portions. Her white blood cell rely was regular, and the docs decided that no additional therapy was required.
What makes the case distinctive: Sparganosis infections sometimes seem in tissues situated just below the pores and skin, close to the floor of the physique. They hardly ever migrate to the inner organs. That is the primary case to be documented in Shanghai of sparganosis within the lungs, the case report authors wrote.
Consuming uncooked animal flesh is a long-standing cultural custom in components of Asia, and typically, small animals could also be consumed whereas they’re nonetheless alive. Residing frogs are often eaten as a folklore treatment for a wide range of illnesses; an 82-year-old lady in Hangzhou was hospitalized with a parasitic an infection after she swallowed eight small, stay frogs in an try to alleviate her persistent again ache.
For extra intriguing medical instances, try our Diagnostic Dilemma archives.
This text is for informational functions solely and isn’t meant to supply medical recommendation.
