Internal Medicine

0521779407-13 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:15

926 Lung Fluke

■Other tests: Chest X-ray often shows scattered opacities in early stage,

later cysts, scarring, small effusions. Serology helpful, done by CIE

(at CDC).

differential diagnosis

■Pulmonary form: tuberculosis, other chronic infections, COPD, car-

cinoma

■During migration: other causes of abdominal pain

management

What to Do First

■Assess severity of infection, and look for ectopic disease (brain,

abdomen).

General Measures

■Determine source of infection, educate patient, ensure good nutri-

tion.

specific therapy

Indications

■All patients

Treatment Options

■Praziquantel for 3 days: generally curative.

Triclabendazole (compassionate use)

Side Effects & Complications

■May have abdominal pains, wheeze, relating to death of worms

➣Contraindications to treatment: absolute: allergy to medication

➣Contraindications to treatment: relative: none

follow-up

During Treatment

■Monitor symptoms.

Routine

■Check stools, sputum (if available) for ova 2–4 weeks after treatment.

Obtain chest X-ray at intervals.

complications and prognosis

■Main complication is ectopic worms, especially in brain, which can

cause seizures, headache, focal neurologic signs, coma. Treatment

is with praziquantel with steroid coverage. Abdominal worms can