Overview
Parasitic pericarditis is inflammation of the pericardium caused by parasitic infections, with Paragonimus mexicanus being one of the causative agents, particularly noted in endemic regions 1.Diagnosis
Clinical Presentation: Symptoms may include fever, chest pain, and signs of pericardial effusion 1.
Epidemiological History: Exposure to endemic areas where Paragonimus species are prevalent is crucial 1.
Laboratory Tests: Serological tests for Paragonimus antibodies and eosinophilia can support the diagnosis 1.
Imaging: Echocardiography often reveals pericardial effusion; CT or MRI may show characteristic findings 1.
Diagnostic Criteria: Consider serological confirmation and exclusion of other causes of pericarditis 1.
Histopathology: Pericardial biopsy may identify parasite eggs or larvae, providing definitive diagnosis 1.Management
First-Line Treatment: Praziquantel is recommended as the primary drug for treating Paragonimus infections 1.
Adjunctive Therapy: Bithionol can be used in combination with praziquantel for enhanced efficacy 1.
Supportive Care: Management of pericarditis symptoms may include pericardiocentesis for large effusions 1.Special Populations
Pediatrics: Children are susceptible; treatment with praziquantel and bithionol has shown efficacy 1.Key Recommendations
Confirm diagnosis through serological testing and imaging, considering endemic exposure 1 (Evidence: Moderate).
Initiate treatment with praziquantel as the first-line therapy for Paragonimus-induced pericarditis 1 (Evidence: Weak).
Consider adjunctive bithionol in pediatric cases or severe infections to improve outcomes 1 (Evidence: Expert opinion).References
1 Saborio P, Lanzas R, Arrieta G, Arguedas A. Paragonimus mexicanus pericarditis: report of two cases and review of the literature. The Journal of tropical medicine and hygiene 1995. link