title: Intestinal paragonimiasis with colonic ulcer and hematochezia in an elderly Taiwanese woman.
abstract: A 94-year-old female with end-stage renal disease presents with fever, fatigue, and hematochezia. She had previously resided in Hunan Province, China, and Myanmar, and she immigrated to Taiwan 30 years ago. Colonoscopy revealed a colonic ulcer. Biopsy of the colonic ulcer showed ulceration of the colonic mucosa, and many Paragonimus westermani-like eggs were noted. Serum IgG antibody levels showed strong reactivity with P. westermani excretory-secretory antigens by ELISA. Intestinal paragonimiasis was thus diagnosed according to the morphology of the eggs and serologic finding. After treatment with praziquantel, hematochezia resolved. The present case illustrates the extreme manifestations encountered in severe intestinal paragonimiasis.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, 250 Wu-Xing Street, Taipei 11031, Taiwan.
authors.forename: Chung-Te
authors.initials: CT
authors.lastname: Liu
authors.forename: Yen-Cheng
authors.initials: YC
authors.lastname: Chen
authors.forename: Tso-Hsiao
authors.initials: TH
authors.lastname: Chen
authors.forename: Ursula
authors.initials: U
authors.lastname: Barghouth
authors.forename: Chia-Kwung
authors.initials: CK
authors.lastname: Fan
mesh_terms: D000369:Aged, 80 and over; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D000909:Antibodies, Helminth / Q000097:blood; D000947:Antigens, Helminth / Q000276:immunology; D003108:Colonic Diseases / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D003113:Colonoscopy; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000150:complications / Q000188:drug therapy / Q000469:parasitology / Q000473:pathology*; D007676:Kidney Failure, Chronic / Q000150:complications; D010237:Paragonimiasis / Q000150:complications / Q000188:drug therapy / Q000469:parasitology / Q000473:pathology*; D048492:Paragonimus westermani / Q000276:immunology*; D011223:Praziquantel / Q000627:therapeutic use; D013624:Taiwan; D014456:Ulcer / Q000150:complications / Q000188:drug therapy / Q000473:pathology*
chemical_list: D000871:Anthelmintics; D000909:Antibodies, Helminth; D000947:Antigens, Helminth; D011223:Praziquantel