Not a Fluke: Pulmonary Manifestations of Parasitic Infection

Parasitic infections affect approximately two billion people globally, most commonly in developing countries in the tropics and subtropical regions. However, they are being seen in developed countries with increasing frequency due to immigration and travel. Many parasitic infections present with nonspecific and overlapping clinical findings, and many present with chest involvement. Thoracic manifestations of parasitic infection can be subdivided into 2 major categories: those that result in nondestructive-type physiological response with patchy, migratory, and transient pulmonary opacities, and those that undergo a locally destructive-type manifestation with lung cysts or linear tracts, smooth muscle denervation, chronic and recurrent inflammation, or even osseous destruction. Considering a third nontraditional category of parasitic infections that rarely result in thoracic pathology can be a useful diagnostic tool to broaden the differential diagnosis and assist the radiologist in considering additional pathogen disease patterns. Recognizing the temporal, zonal, and other classic thoracic manifestations in conjunction with the common systemic imaging findings can assist in accurate and timely diagnosis.