Related Experiment Video
Updated: Jun 13, 2026
Visualization of Streptococcus pneumoniae within Cardiac Microlesions and Subsequent Cardiac Remodeling
Published on: April 7, 2015
[A case of Paragonimus westermani complicated empyema by Streptococcus pneumoniae]
Towako Nagata1, Hiroshi Mukae, Youji Futsuki
1Department of Internal Medicine, Omura City Hospital.
Abstract:
A 75-year-old man, who had eaten wild boar and deer repeatedly until November 2006, visited our hospital because of a right pleural effusion on chest X-ray films after he bruised a hip in January 2007. A right thoracocentesis revealed exudative pleural effusion with many neutrophils. Ten days after his first visit, a pleural biopsy specimen suggested the existence of parasite eggs. Twenty-six days after his first visit, he was admitted to our hospital because of leukocytosis, increased systemic inflammatory markers and a right pleural effusion. We found a great number of neutrophils, eggs of the Paragonimus species and gram-positive cocci in the pleural effusion. Streptococcus pneumoniae was also identified in his pleural effusion. In addition, a diagnosis of Paragonimiasis westermani was made serological study. After the continuous drainage of the pleural effusion, the patient was treated with praziquantel and antibiotics, and he gradually improved.
Insights
A case of Paragonimiasis westermani complicated by bacterial pneumonia in a 75-year-old man is presented. Prompt diagnosis and treatment with praziquantel and antibiotics led to patient recovery.
Area of Science:
- Parasitology
- Infectious Diseases
- Pulmonology
Background:
- Paragonimiasis westermani is a parasitic lung infection caused by ingesting raw or undercooked freshwater crustaceans.
- Pleural effusion is a known complication of Paragonimiasis westermani.
Observation:
- A 75-year-old man presented with right pleural effusion after consuming wild boar and deer.
- Thoracentesis revealed exudative effusion with neutrophils, parasite eggs (Paragonimus species), and gram-positive cocci.
Findings:
- The patient was diagnosed with Paragonimiasis westermani via serological study.
- Streptococcus pneumoniae was co-identified in the pleural effusion, indicating bacterial pneumonia.
- The pleural effusion contained a significant number of neutrophils, Paragonimus eggs, and bacteria.
Implications:
- This case highlights the importance of considering Paragonimiasis westermani in patients with unexplained pleural effusion, especially with a history of consuming raw or undercooked crustaceans.
- Concurrent bacterial pneumonia can complicate Paragonimiasis westermani, necessitating prompt diagnosis and combined antiparasitic and antibiotic treatment.
- Successful management involved continuous pleural fluid drainage, praziquantel for the parasitic infection, and antibiotics for bacterial pneumonia.
Related Concept Videos
01:29Pneumonia I: Introduction
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:30Pneumonia III: Complications and Assessment
01:14Atypical Pneumonia
01:29Pneumonia II: Pathophysiology
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include: