Analysis of clinical characteristics of 213 clinically diagnosed pediatric patients with paragonimiasis from Yunnan, China.

Abstract

Objective: This study aims to analyze the clinical characteristics of clinically diagnosed paragonimiasis in children in Yunnan Province to enhance awareness, reduce misdiagnosis and missed diagnoses, and provide guidance for the clinical management of the disease.

Methods: Clinical data from 213 pediatric patients clinically diagnosed with paragonimiasis between 2014 and April 2024 were collected and retrospectively analyzed, focusing on clinical symptoms, laboratory findings, imaging changes, and treatment approaches.

Results: Among the 213 cases, the majority were male (157 cases, 73.7%), with Han ethnicity being the most prevalent (161 cases, 75.6%), and the average age was 7.2 years. The majority of cases originated from Zhaotong City, Yunnan Province (159/213, 74.6%), particularly from Zhenxiong County (90/159, 56.6%), Yiliang County (31/159, 19.5%), and Daguan County (24/159, 15.1%). A clear epidemiological exposure history was present in 177 cases (83.1%), including the consumption of raw water, crayfish, and stream crabs. The most common clinical subtypes were complex (115 cases, 54.0%) and thoracic-pulmonary (83 cases, 39.0%). The three most prevalent clinical manifestations included cough (98 cases, 48.0%), fever (75 cases, 35.2%), and abdominal pain (63 cases, 29.6%). Elevated eosinophil levels were noted in 195 cases (91.5%). Compared to the thoracic-pulmonary subtype, the complex subtype exhibited higher proportions of Han ethnicity, Zhaotong origin, White cell count, hemoglobin levels, and length of hospitalization. All children received oral praziquantel treatment, averaging 2.6 treatment courses, with 121 cases (56.8%) also receiving glucocorticoid therapy, and 45 cases (21.1%) undergoing surgical intervention. Except for five thoracic-pulmonary subtype patients who sought surgery at external facilities, all other patients were discharged after clinical improvement. Follow-up indicated that 143 cases (67.1%) attended regular check-ups, with no residual complications.

Conclusion: The clinical manifestations of clinically diagnosed paragonimiasis are diverse. In addition to immunological examinations and elevated eosinophil counts, an epidemiological history (including residence in endemic areas and consumption of raw water or crayfish) is crucial for diagnosis. After treatment primarily with praziquantel, the prognosis for the majority of patients is favorable.

Clinical trial number: Not applicable.