Abstract
The high prevalence of tuberculosis in recent Indochinese refugees of all ages is well documented, with 100-fold greater prevalence in 5-14-year-olds compared to others in this age group in the U.S.A. However, other possible etiologies for chronic pulmonary disease must also be considered in such children. During a recent 12-month period, pulmonary paragonimiasis was diagnosed in three 8- to 11-year-old Laotian children living in the Chicago area. Clinical manifestations of illness included lack of fever or sweats, absent family history of TB, chronic cough for 2 weeks to 2 years, and apparent hemoptysis in 2 patients. Physical findings included rales and dullness to percussion (3/3), lack of respiratory distress (3/3), and clubbing (1/3). All patients showed interstitial pulmonary infiltrates on chest x-ray, while 2 had multiple small cystic areas. Moderate eosinophilia ranging from 5-13% (absolute counts from 770-1290/mm3) was present. Paragonimus westermani ova were found in stools of 2 patients. The etiology of pulmonary disease was established by demonstrating P. westermani ova in expectorated sputum (2) or bronchoscopic specimens (1). All patients were treated orally with Bithionol 50 mg/kg every other day for 15 doses, without side effects. Two patients demonstrated clinical and radiologic improvement; one was lost to follow-up. Clinicians must consider lung fluke infestation in refugee children who present with tuberculin-negative chronic pulmonary disease.
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Shulman, S., Yogev, R., Burton, K. et al. 691 PULMONARY PARAGONIMIASIS IN INDOCHINESE REFUGEE CHILDREN. Pediatr Res 15 (Suppl 4), 557 (1981). https://doi.org/10.1203/00006450-198104001-00714
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DOI: https://doi.org/10.1203/00006450-198104001-00714
