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Pulmonary paragonimiasis.

Th Nabakumar Singh1, H Rebachandra Singh, Kh Sulochana Devi

  • 1Department of Microbiology, Regional Institute of Medical Sciences, Imphal, Manipur, India. nadakr@rediffmail.com

The Indian Journal of Chest Diseases & Allied Sciences
|November 24, 2004
PubMed
Summary

A patient with persistent respiratory symptoms initially treated for tuberculosis was diagnosed with Paragonimus westermani infection. Prompt praziquantel treatment led to a full recovery, highlighting the importance of considering parasitic lung infections.

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Area of Science:

  • Medical Parasitology
  • Pulmonology
  • Infectious Diseases

Background:

  • Tuberculosis is a common diagnosis for persistent cough and lung lesions.
  • Parasitic lung infections can mimic bacterial or fungal pneumonia, complicating diagnosis.
  • Geographic location and dietary habits are crucial in identifying potential parasitic exposures.

Observation:

  • A 27-year-old male presented with prolonged cough, fever, hemoptysis, anorexia, and weight loss, unresponsive to a year of anti-tuberculosis therapy.
  • Chest imaging showed a cavitary lesion in the right midzone, with peripheral blood eosinophilia and elevated ESR.
  • Sputum analysis confirmed the presence of Paragonimus westermani eggs.

Findings:

  • The patient was diagnosed with pulmonary paragonimiasis, a parasitic lung infection caused by Paragonimus species.

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  • Treatment with praziquantel (25 mg/kg, three times daily for three days) resulted in significant clinical improvement.
  • Follow-up indicated the patient was doing well, with resolution of symptoms.

    • Implications:

    • Pulmonary paragonimiasis should be considered in the differential diagnosis of non-resolving pneumonia, particularly in endemic areas.
    • Early and accurate diagnosis of Paragonimus infection is essential for effective treatment and patient outcomes.
    • Praziquantel is an effective and rewarding treatment for pulmonary paragonimiasis, preventing prolonged morbidity associated with misdiagnosis.