Cases reported "Lung Diseases, Parasitic"

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1/3. Pulmonary anisakiasis presenting as eosinophilic pleural effusion.

    A 63-year-old man developed a pleural effusion with marked eosinophilia, which was more prominent in the pleural fluid than in the peripheral blood. The pleural effusion spontaneously disappeared 7 days after admission. A multiple dot enzyme-linked immunosorbent assay for anisakiasis was strongly positive for both the serum and pleural fluid. The serum IgG titre for anisakis simplex gradually decreased over 7 months. It is suspected that anisakis larvae can penetrate the alimentary canal, and then migrate into the pleural cavity through the diaphragm. Screening with a serological test is useful in the diagnosis of this condition; human pulmonary anisakiasis.
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2/3. Probable pulmonary anisakiasis accompanying pleural effusion.

    The first probable human case of pulmonary anisakiasis is reported. A 37-year-old Japanese person in california developed pleural effusion after consumption of raw salmon at a seafood restaurant in san francisco. A marked eosinophilia was noted in the blood and pleural exudate. The patient was tested for helminthic infections by intradermal, complement fixation, Ouchterlony, and immunoelectrophoresis tests using antigens of various worm species. A specific precipitin band was recognized only with anisakis (Type I larvae) antigen.
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3/3. A case report of serologically diagnosed pulmonary anisakiasis with pleural effusion and multiple lesions.

    The second known human case of pulmonary anisakiasis is reported. A 22-years-old man living in Hyuga City, Miyazaki Prefecture, japan, developed high fever, respiratory distress, and pleural effusion after consumption of raw fish. Although his total white blood cell count increased to approximately 10,000-20,000/mm3, eosinophilia was not observed. The total IgE level in his serum markedly increased up to 3,599 IU/ml. Since the patient was suspected to have a parasitic disease, immunoserologic tests were carried out. Screening tests using a multiple dot-enzyme-linked immunosorbent assay (ELISA) and an Ouchterlony double-diffusion test showed that his serum and pleural effusion had the strongest reactivity against crude antigen of anisakis type I larvae, together with weak cross-reactivity against several other nematode antigens. Since extragastrointestinal anisakiasis was strongly suspected, this diagnosis was confirmed by a microplate-ELISA and Western blot analysis using a monoclonal antibody.
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