Chinese Medical Journal

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RECENT ADVANCES IN DIAGNOSIS OF PARAGONIMIASIS 15

3. Summary of the main autopsy findings of 2 very instructive cases (Case 1 and Case 2) are given in some detail. The postmortem findings have fully proved the value of these diagnostic procedures and the unwisdom of relying too much on the findings of certain highly specialized laboratory methods of diagnosis. In these 2 cases the roentgenological findings of the chest, the electrocardiographical changes, and the reported discovery of “tubercle bacilli” in the cerebrospinal fluid, obviously due to laboratory error, were disproved by the autopsy findings. Both the patients had no tuberculosis either of the lungs or the meninges but had paragonimiasis with fatal cerebral involvement and adhesions between the chest wall, the lungs, the pericardial sac and the diaphragm.

4. Two new endemic areas of paragonimiasis were discovered through the diagnosis of 2 exogenous cases (from Kirin and Szechuan provinces) seen in Peking. These cases would have been missed had it not been for the fact that the new diagnostic triad was carefully applied.

5. The proposed diagnostic triad constitutes a very useful weapon in surveys of and campaigns against paragonimiasis, as it facilitates early and accurate diagnosis. According to our recent experience in Kwangtung province the same principles, particularly the skin test, may be applied with advantage in surveys of and campaigns against parasitic diseases like schistosomiasis, clonorchiasis, ete.

6. The intradermal test is a very convenient and fairly reliable procedure for screening paragonimiasis cases in epidemiological surveys. Only skin-test positive cases need be subjected to sputum examination for paragonimus ova and serum complement fixation test.

REFERENCES

1. Chung Huei-Lan, Ch’en Chien-Hung, and Hou Tsung-Ch’ang, Preliminary

observations on efficacy of chloroquine in treatment of paragonimiasis; a report of three cases, Chinese M. J. 72:1-14, 1954.

Chung, H. L., and Hou, T: C., Recent advance in chemotherapy of paragonimiasis; further observations on efficacy of chloroquine in treatment of paragonimiasis, Chinese J. Int. Med. (in Chinese) (4) :324-336, 1954.

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Chung Huei-Lan, and Hou Tsung-Ch’ang, Chemotherapy of paragonimiasis;

further observations on the efficacy of chloroquine, Chinese M. J. 72:407-427, 1954.

4. Chung Huei-Lan, Wei Vii-Lin, Hou Tsung-Ch’ang, Feng Ch’uan-Yi, and Weng Hsin-Chih, Clinical observations on fourteen cases of cerebrospinal paragonimiasis, Nat. Med. J. China (in Chinese) (10) :767-779, 1954.

5. Chung Huei-Lan, Hou Tsung-Ch’ang, Weng Hsin-Chih, and Ho Lien-Yin,

The diagnostic value of paragonimiasis complement fixation test, Nat. Med. J. China (in Chinese) (3) :178-179, 1954.