Progress on prevention and misdiagnosis of paragonimiasis

doi:10.3877/cma.j.issn.1674-1358.2020.03.002

Abstract

Abstract:

To review the progression of clinical diagnosis and treatment in paragonimiasis (LFD), and to avoid the misdiagnosis and mistreatment. Total of 155 articles from Wanfang, Weipu and CNKI Databases were retrieved from January 2009 to June 2019 with the key word of "Paragonimiasis" . There were 94 (58.06%) articles of headlines including "misdiagnosis" . The rate of first diagnosis was only 11.40%, and the misdiagnosis rate was as high as 68.73%-88.60%. The causes of misdiagnosis included insufficient understanding of the epidemiology of LFD, carelessness in history-taking and physical examination, lack of the scientific analysis of laboratory and imaging examination and definitive diagnostic method. By reviewing the related literatures and combining clinical experience, the following measures could be taken to prevent misdiagnosis: firstly, strengthen the "three bases" (basic theory, basic knowledge, basic skills) training, the current medical history, personal history of scientific inquiries, looking for clues to the invasion of paragonimiasis; secondly, strengthen the "three-base" physical examination training such as attention to chest and lung type LFD "signs and body temperature separation phenomenon" ; thirdly, strengthen the "three-base" routine test, imaging results analysis training, identification of white blood cell (WBC) and eosinophil (EOS) abnormal changes; fourthly, to develop the method to promote paragonimus antigen and antibody detection such as paragonimus antigen intradermal test (PAI); Fifthly, pay attention to the epidemiological changes of infectious diseases. The misdiagnosis of LFD could be avoided with the medical history in detailed, careful physical examination, scientific analysis on laboratory and imaging results, and necessary antigen-antibody detection.

Key words: Paragonimiasis, Misdiagnosis, Prevention, Progress

Yinghai Cao, Shan Li, Xu Lei, Zhixiong Lei, Jian Li, Jing Yang, Huabing Tan. Progress on prevention and misdiagnosis of paragonimiasis[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2020, 14(03): 186-190.

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