{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T11:29:33Z","timestamp":1779103773327,"version":"3.51.4"},"reference-count":18,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:00:00Z","timestamp":1745452800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003996","name":"Kunming Medical University","doi-asserted-by":"publisher","award":["202101AY070001\u2014217"],"award-info":[{"award-number":["202101AY070001\u2014217"]}],"id":[{"id":"10.13039\/501100003996","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Kunming Health Science and Technology Personnel Training Project","award":["2020 (Province)-21"],"award-info":[{"award-number":["2020 (Province)-21"]}]},{"name":"Yunnan Key Specialty of Pediatric Infection Training and Education Program","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Key Science and Technology Program of Yunnan Province","award":["No.202102AA100019"],"award-info":[{"award-number":["No.202102AA100019"]}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Pericardial effusion is a severe complication of pediatric paragonimiasis, necessitating a careful approach to diagnosis and treatment. Traditionally, the management of pericardial effusion pericardial effusion due to paragonimiasis has involved surgical intervention to drain the accumulated fluid, especially in severe cases. However, the use of non-surgical treatment approaches, such as praziquantel and corticosteroids, have shown promise in certain cases, potentially avoiding the need for invasive procedures.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Objective<\/jats:title>\n<jats:p>To analyze the clinical features and treatment outcomes of pediatric patients with paragonimiasis complicated by moderate to large pericardial effusion, with particular emphasis on comparing surgical and non-surgical treatment approaches, thereby providing clinical evidence for non-surgical treatment in such cases.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a retrospective analysis of clinical data from patients diagnosed with paragonimiasis at Kunming Children\u2019s Hospital between January 2014 and April 2023. The patients were divided into pericardial effusion group and thoracopulmonary group. Then the pericardial effusion group was further subdivided into surgical and non-surgical groups. The clinical data were compared between the two groups. Categorical variables were compared using the \u03c7\u00b2 test, while continuous variables were compared using the t-test or Mann-Whitney U test. Further follow-up was conducted to assess the treatment outcomes in both the surgical and non-surgical groups.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Compared to the thoracopulmonary group (n\u2009=\u200961), patients with pericardial effusion (n\u2009=\u200935) were more likely to present with dyspnea, weak heart sounds, abdominal pain\/bloating, and vomiting, and a shorter pre-admission disease course, but significantly longer hospital stays and higher costs. There were no statistically significant differences in clinical presentation, white blood cell count, eosinophil count, pre-admission disease course, or oral praziquantel course between the surgical and non-surgical groups. Notably, pericardial effusion resolved in both groups, but the surgical group had significantly higher hospital costs and longer stays.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>In the endemic areas of paragonimiasis,in cases of moderate to severe pericardial effusion a thorough epidemiological history should be taken, and paragonimiasis should be considered. In the absence of life-threatening conditions, early praziquantel treatment, combined with low-dose corticosteroids and regular echocardiography follow-up, can avoid unnecessary surgical intervention if effusion absorption is observed. However, the conclusion of this study is based on limited evidence, and further multicenter, prospective randomized controlled trials are needed to validate the findings.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0013023","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T17:25:49Z","timestamp":1745515549000},"page":"e0013023","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Pericardial effusion in pediatric paragonimiasis: Surgery may not be necessary in cases of moderate to large effusion\u2014a retrospective study"],"prefix":"10.1371","volume":"19","author":[{"given":"Houxi","family":"Bai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanchun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaotao","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Jiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3167-4599","authenticated-orcid":true,"given":"Yonghan","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,4,24]]},"reference":[{"issue":"7","key":"pntd.0013023.ref001","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.pt.2008.03.014","article-title":"Paragonimiasis: an important food-borne zoonosis in China","volume":"24","author":"Q Liu","year":"2008","journal-title":"Trends Parasitol"},{"issue":"3","key":"pntd.0013023.ref002","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.pt.2012.12.004","article-title":"Have foodborne parasites finally become a global concern?","volume":"29","author":"LJ Robertson","year":"2013","journal-title":"Trends Parasitol"},{"key":"pntd.0013023.ref003","doi-asserted-by":"crossref","first-page":"106094","DOI":"10.1016\/j.actatropica.2021.106094","article-title":"Paragonimus and its hosts in China: An update","volume":"223","author":"X-J Zhou","year":"2021","journal-title":"Acta Trop"},{"issue":"4","key":"pntd.0013023.ref004","first-page":"505","article-title":"Paragonimiasis in chinese children: 58 cases analysis","volume":"22","author":"HZ Xu","year":"2012","journal-title":"Iran J Pediatr"},{"key":"pntd.0013023.ref005","doi-asserted-by":"crossref","first-page":"1143262","DOI":"10.3389\/fped.2023.1143262","article-title":"Pediatric paragonimiasis: a retrospective analysis of cases from a county in south-west China","volume":"11","author":"Y-X Jiang","year":"2023","journal-title":"Front Pediatr"},{"key":"pntd.0013023.ref006","doi-asserted-by":"crossref","first-page":"e01075","DOI":"10.1016\/j.idcr.2021.e01075","article-title":"Paragonimus infection: Rare manifestation with pericardial effusion: A Case report and Literature review","volume":"24","author":"A Al Bishawi","year":"2021","journal-title":"IDCases"},{"issue":"25","key":"pntd.0013023.ref007","doi-asserted-by":"crossref","first-page":"e7265","DOI":"10.1097\/MD.0000000000007265","article-title":"Paragonimiasis in Children in Southwest China: A retrospective case reports review from 2005 to 2016","volume":"96","author":"Z Gong","year":"2017","journal-title":"Medicine (Baltimore)"},{"key":"pntd.0013023.ref008","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.ijid.2019.03.032","article-title":"Diagnosis and surgical management of pericardial effusion due to paragonimiasis","volume":"83","author":"Y Wu","year":"2019","journal-title":"Int J Infect Dis"},{"key":"pntd.0013023.ref009","unstructured":"National Health Commission of the People\u2019s Reople\u2019s Republic of China. Diagnosis of paragonimiasis (WS 380-2012). 2012."},{"issue":"1","key":"pntd.0013023.ref010","doi-asserted-by":"crossref","first-page":"137","DOI":"10.3390\/medicina59010137","article-title":"A Cluster of Paragonimiasis with Delayed Diagnosis Due to Difficulty Distinguishing Symptoms from Post-COVID-19 Respiratory Symptoms: A Report of Five Cases","volume":"59","author":"J Sasaki","year":"2023","journal-title":"Medicina (Kaunas)"},{"issue":"4","key":"pntd.0013023.ref011","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1111\/neup.12841","article-title":"A case of cerebral paragonimiasis misdiagnosed as eosinophilic granulomatosis with polyangiitis","volume":"42","author":"S Yamamuro","year":"2022","journal-title":"Neuropathology"},{"issue":"1","key":"pntd.0013023.ref012","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s13019-021-01408-y","article-title":"Analysis of the misdiagnosis of 8 adult cases of paragonimiasis with lung masses as the main manifestation in Xishuangbanna, Yunnan","volume":"16","author":"QH Shu","year":"2021","journal-title":"J Cardiothorac Surg"},{"issue":"4","key":"pntd.0013023.ref013","doi-asserted-by":"crossref","first-page":"178","DOI":"10.4046\/trd.2014.77.4.178","article-title":"A Case of Delayed Diagnosis of Pulmonary Paragonimiasis due to Improvement after Anti-tuberculosis Therapy","volume":"77","author":"S Lee","year":"2014","journal-title":"Tuberc Respir Dis (Seoul)"},{"key":"pntd.0013023.ref014","doi-asserted-by":"crossref","first-page":"e484","DOI":"10.7717\/peerj.484","article-title":"The mitochondrial genome of Paragonimus westermani (Kerbert, 1878), the Indian isolate of the lung fluke representative of the family Paragonimidae (Trematoda)","volume":"2","author":"DK Biswal","year":"2014","journal-title":"PeerJ"},{"issue":"12","key":"pntd.0013023.ref015","article-title":"Blood eosinophilia and parasitic infection.","volume":"41","author":"M Zheng"},{"issue":"5","key":"pntd.0013023.ref016","first-page":"441","article-title":"Acute Pericarditis: Rapid Evidence Review","volume":"109","author":"TA Peterson","year":"2024","journal-title":"Am Fam Physician"},{"key":"pntd.0013023.ref017","doi-asserted-by":"crossref","first-page":"900701","DOI":"10.3389\/fphar.2022.900701","article-title":"The therapeutic effect of glucocorticoids on type II respiratory failure, heart failure, and massive pericardial effusion caused by hypothyroidism: A case report","volume":"13","author":"J Wang","year":"2022","journal-title":"Front Pharmacol"},{"issue":"51","key":"pntd.0013023.ref018","doi-asserted-by":"crossref","first-page":"e13708","DOI":"10.1097\/MD.0000000000013708","article-title":"Cardiac tamponade as the initial symptom due to systemic lupus erythematosus in a young man: A case report","volume":"97","author":"X Zhang","year":"2018","journal-title":"Medicine (Baltimore)"}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013023","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T17:25:56Z","timestamp":1745515556000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013023"}},"subtitle":[],"editor":[{"given":"Aysegul","family":"Taylan Ozkan","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,4,24]]},"references-count":18,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4,24]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0013023","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,24]]}}}