Choi JW, Lee CM, Kim SJ, Hah SI, Kwak JY, Cho HC, Ha CY, Jung WT, Lee OJ. Ectopic peritoneal paragonimiasis mimicking tuberculous peritonitis: A care report. World J Clin Cases 2022; 10(16): 5359-5364 [PMID: 35812672 DOI: 10.12998/wjcc.v10.i16.5359]
Corresponding Author of This Article
Chang Min Lee, MD, Assistant Professor, Department of Internal Medicine, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Gangnamro 79, Jinju 52727, South Korea. cmleesam@gnuh.co.kr
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jun 6, 2022; 10(16): 5359-5364 Published online Jun 6, 2022. doi: 10.12998/wjcc.v10.i16.5359
Ectopic peritoneal paragonimiasis mimicking tuberculous peritonitis: A care report
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
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, Department of Internal Medicine, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju 52727, South Korea
Chang Min Lee, Hyun Chin Cho, Chang Yoon Ha, Woon Tae Jung, Ok Jae Lee, Institute of Health Sciences, Gyeongsang National University, Jinju 52828, South Korea
Author contributions: Lee CM contributed to the collection and organization of data; Choi JW wrote the draft; Kim SJ, Hah SI, and Kwak JY, Cho HC, Ha CY, Jung WT, and Lee OJ revised the manuscript for important intellectual content; All authors have read and approved the final manuscript.
Informed consent statement: A patient was not required to give informed consent for the study because this is a study that analyzed data retrospectively at a specific point that had already been completed in the treatment process. In the entire research process, including clinical data collection, analysis, and manuscript preparation, the possibility of infringing on the human rights of the subject patient is judged to be minimal, and the confidentiality of the subject patient’s personal information has been thoroughly maintained. Therefore, it is considered that the procedure for obtaining written consent from the subject patient can be omitted.
Conflict-of-interest statement: No conflicts exist for any author.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chang Min Lee, MD, Assistant Professor, Department of Internal Medicine, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Gangnamro 79, Jinju 52727, South Korea. cmleesam@gnuh.co.kr
Received: August 7, 2021 Peer-review started: August 7, 2021 First decision: October 2, 2021 Revised: October 7, 2021 Accepted: April 2, 2022 Article in press: April 2, 2022 Published online: June 6, 2022 Processing time: 299 Days and 4.4 Hours
Abstract
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.
Core Tip: Intraperitoneal Paragonimus without lung involvement can be misdiagnosed for tuberculous peritonitis, even with a negative stool test and normal eosinophil counts. In this case, a positive result on the preoperative serum antibody test for P. westmani may help patients recall history of crustacean consumption and prevent unnecessary surgery.
