[Pulmonary paragonimiasis. Case report]

Area of Science:

• Infectious Diseases
• Parasitology
• Public Health

Background:

• Paragonimiasis is a zoonotic parasitic disease caused by Paragonimus trematodes, primarily affecting humans through the consumption of raw or undercooked freshwater crustaceans.
• The genus Paragonimus includes various species responsible for zoonotic infections in both animals and humans worldwide.

Observation:

• A 3-year-old child residing in Ecuador presented with respiratory distress, hepatomegaly, and nodules after consuming raw crab ceviche.
• Thoracic CT scans revealed significant pulmonary infiltrates and pleural compromise, alongside marked eosinophilia (47%).

Findings:

• Despite negative Paragonimus egg detection in sputum and feces, a diagnosis of pulmonary paragonimiasis was confirmed via clinical presentation, imaging, eosinophilia, and positive ELISA/Western blot results.
• Treatment with Praziquantel (25 mg/kg/day) for three days led to the resolution of symptoms and significant reduction in radiological findings and eosinophil counts.

Implications:

• This case highlights pulmonary paragonimiasis as a differential diagnosis in children with respiratory symptoms and eosinophilia, particularly in endemic areas with a history of consuming raw crustaceans.
• Early diagnosis and Praziquantel treatment are crucial for managing Paragonimus infections, underscoring the importance of public health awareness regarding safe food consumption practices.