Ectopic peritoneal paragonimiasis mimicking tuberculous peritonitis:A care report  

作　　者：Jung Woo Choi Chang Min Lee Seong Je Kim Se In Hah Ji Yoon Kwak Hyun Chin Cho Chang Yoon Ha Woon Tae Jung Ok Jae Lee 

机构地区：[1]Department of Internal Medicine,Gyeongsang National University College of Medicine and Gyeongsang National University Hospital,Jinju 52727,South Korea [2]Institute of Health Sciences,Gyeongsang National University,Jinju 52828,South Korea

出　　处：《World Journal of Clinical Cases》2022年第16期5359-5364,共6页世界临床病例杂志

摘　　要：BACKGROUND The most common site of paragonimiasis is in the lungs.The migratory route passes through the duodenal wall,peritoneum,and diaphragm to the lungs;thus,the thoracic cavity and central nervous system,as well as the liver,intestine,and abdominal cavity may be involved.Here,we present a case of intraperitoneal paragonimiasis without other organ involvement,mimicking tuberculous peritonitis.CASE SUMMARY A 57-year-old man presented with recurrent abdominal pain for 4 wk.Physical examination revealed tenderness in the right lower quadrant.Laboratory findings showed complete blood counts within the normal range without eosinophilia.Multiple reactive lymph nodes and diffuse peritoneal infiltration were noted on abdominal computed tomography(CT).There were no abnormalities on chest CT or colonoscopy.Intraoperative findings of diagnostic laparoscopy for the differential diagnosis of tuberculous peritonitis and peritoneal carcinomatosis included multiple small whitish nodules and an abscess in the peritoneum.Pathological reports confirmed the presence of numerous eggs of Paragonimus westermani(P.westermani).A postoperative serum enzyme-linked immunosorbent assay revealed P.westermani positivity.Persistent and repetitive history-taking led him to retrospectively recall the consumption of freshwater crab.After 3 d of treatment with praziquantel(1800 mg;25 mg/kg),he recovered from all symptoms.CONCLUSION In patients who require diagnostic laparoscopy for the differential diagnosis of tuberculous peritonitis and peritoneal carcinomatosis,repetitive history-taking and preoperative serologic antibody tests against Paragonimus may be helpful in diagnosing intraperitoneal paragonimiasis without other organ involvement.

关 键 词：Differential diagnoses Intraperitoneal abscess PARAGONIMIASIS Paragonimus westermani PERITONITIS Tuberculosis Case report 

分 类 号：R532.2[医药卫生—内科学]