The primary parasites found in pleural fluid are Entamoeba histolytica, Echinococcus granulosus, and Paragonimus westermani. These parasites can cause a range of pleural issues, from simple effusions to more severe conditions.
Common Parasites Affecting the Pleura
Here's a breakdown of how these parasites affect the pleura:
Entamoeba histolytica
- Amebiasis and Empyema: Entamoeba histolytica, which causes amebiasis, can lead to empyema. This is a collection of pus in the pleural space.
- “Anchovy Sauce” Pus: The pus associated with Entamoeba histolytica empyema is often described as having an "anchovy sauce" appearance due to its color and consistency.
- Reactive Pleural Effusions: This parasite can also trigger reactive pleural effusions, where fluid builds up in the pleural space as a reaction to the infection.
- Bronchopleural Fistula: In some cases, amebiasis can lead to a bronchopleural fistula, an abnormal connection between the airway and the pleural space, resulting in hydropneumothorax (fluid and air in the pleural space).
Echinococcus granulosus
- Hydatid Cysts: Echinococcus granulosus forms hydatid cysts, which can sometimes develop within or rupture into the pleural space. This can cause pleuritis (inflammation of the pleura) and effusions.
- Associated Complications: The presence of hydatid cysts in the pleural cavity can cause pain and breathing difficulties.
Paragonimus westermani
- Lung Fluke: Paragonimus westermani, a lung fluke, can cause pleural effusions. The parasite can migrate and cause localized inflammatory reactions in the pleura.
- Clinical Manifestations: Infections of Paragonimus westermani in the pleura often have similar signs to other pleural infections including chest pain and cough.
Summary Table
| Parasite | Pleural Manifestations |
|---|---|
| Entamoeba histolytica | Empyema ("anchovy sauce" pus), reactive pleural effusions, bronchopleural fistula, hydropneumothorax |
| Echinococcus granulosus | Hydatid cysts, pleuritis, effusions |
| Paragonimus westermani | Pleural effusions, inflammatory reactions |
These are the primary parasites identified as commonly affecting the pleura. It is essential to consider these parasites in the differential diagnosis of pleural disease, especially in regions where these parasites are prevalent.
