Serological Diagnosis of North American Paragonimiasis by Western Blot Using Paragonimus kellicotti Adult Worm Antigen

Peter U. Fischer Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri; Heartland Regional Medical Center, St. Joseph, Missouri; Centers for Disease Control and Prevention, Atlanta, Georgia

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Kurt C. Curtis Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri; Heartland Regional Medical Center, St. Joseph, Missouri; Centers for Disease Control and Prevention, Atlanta, Georgia

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Scott M. Folk Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri; Heartland Regional Medical Center, St. Joseph, Missouri; Centers for Disease Control and Prevention, Atlanta, Georgia

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Patricia P. Wilkins Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri; Heartland Regional Medical Center, St. Joseph, Missouri; Centers for Disease Control and Prevention, Atlanta, Georgia

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Luis A. Marcos Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri; Heartland Regional Medical Center, St. Joseph, Missouri; Centers for Disease Control and Prevention, Atlanta, Georgia

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Gary J. Weil Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri; Heartland Regional Medical Center, St. Joseph, Missouri; Centers for Disease Control and Prevention, Atlanta, Georgia

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We studied the value of an IgG Western blot (WB) with Paragonimus kellicotti (Pk) antigen for diagnosis of North American paragonimiasis. The test was evaluated with sera from patients with Pk and Paragonimus westermani infections, with control sera from patients with other helminth infections, and sera from healthy Americans. All 11 proven Pk infection sera and two samples from suspected cases that were negative by P. westermani WB at the Centers for Disease Control and Prevention (CDC) contained antibodies to antigens at 34 kDa and at 21/23 kDa. Seven of 7 P. westermani sera contained antibodies to the 34 kDa antigen, but only 2 recognized the 21/23 kDa doublet. No control samples were reactive with these antigens. Antibody reactivity declined after praziquantel treatment. Thus, the P. kellicotti WB appears to be superior to P. westermani WB for diagnosing Pk infections, and it may be useful for assessing responses to treatment.

Author Notes

* Address correspondence to Peter U. Fischer, Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, 660 S. Euclid Avenue, St. Louis, MO 63110. E-mail: Pufische@DOM.Wustl.edu

Financial support: This study was supported by a grant from the Barnes Jewish Hospital Foundation.

Authors' addresses: Peter U. Fischer, Kurt C. Curtis, Luis A. Marcos, and Gary J. Weil, Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, E-mails: Pufische@DOM.wustl.edu, KCurtis@DOM.wustl.edu, LMarcos@DOM.wustl.edu, and GWeil@DOM.wustl.edu. Scott M. Folk, Heartland Regional Medical Center, St. Joseph, MO, E-mail: scott.folk@heartland-health.com. Patricia P. Wilkins, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: pma1@cdc.gov.

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