Dificultad para el Diagnóstico de Paragonimiasis en atención de Primer Nivel

Abstract

Paragonimiasis is a zoonotic disease , which means that transmission circuit several animal species involved . The disease is often confused with bacterial respiratory infections, especially tuberculosis although most cases go unnoticed producing little discomfort . Especially affects children and young people , has no sex predilection patient and diagnosis can take a long time , from months to several years. ( 1) The case of a male patient of 34 years of occupation operator of heavy machinery at an oil refinery located in a Huorani community is presented, indicates that performing well on Earth is a cetacean (crab) black color, about 3 centimeters in diameter and 1 high, which washes it, you put salt and proceeds to eat him, immediately presents sore throat more difficulty respitoria so attends medical company who administers medication that does not specify to what has allergic reaction so it is administered topical gel and indicated administer alcohol in areas of pruritus, attends private doctor because besides presenting the allergic reaction, also presents diarrheal stools for what concerns was administered loratadine, ibuprofen and antibiotic specified, a month to present this table presents episodes of cough with hemoptysis so go to Subcentro Health Puyo where indicated drink plenty of fluids for the second time comes where you are given more azithromycin ibuprofen for 7 days which does not give the box, then go to another health sub center where it makes Smear for 3 times which leave negative plus a blood count that reports apparently normal moderate eosinophilia 1950 and a chest radiograph throughout this period lasts about 8 months without improvement in picture, goes back to health sub center where it is decided to transfer to secondary hospital where attending physician of Internal Medicine indicates will realize Lowenstein and requests investigate Paragonimus in sputum which reported the presence of Paragonimus so treatment is initiated for 3 days with praziquantel 600 milligrams to take 2 tablets every 8 hours, which evolves favorably with absence of cough with hemoptysis. In our country the first case of paragomnimiasis was reported 93 years ago. There have been reports of an increase in the number of cases of paragonimiasis in the year 1996 with 225 patients and last reported in 2006 with 190. The current situation of cases in the country is unknown since it lacks a rigorous control. (1)