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[A case of paragonimiasis westermani]
1First Department of Internal Medicine, Shinshu University School of Medicine.
Summary
A man with pneumonia-like symptoms was diagnosed with paragonimiasis after eating raw freshwater crabs. Treatment with praziquantel successfully resolved the parasitic lung infection.
Area of Science:
- Medical Parasitology
- Pulmonology
- Infectious Diseases
Background:
- Paragonimiasis, a parasitic lung infection, is often misdiagnosed as pneumonia.
- Consumption of raw or undercooked freshwater crabs is a primary transmission route for Paragonimus species.
Observation:
- A 45-year-old male presented with productive cough and hemoptysis after consuming fried freshwater crabs.
- Initial presentation mimicked pneumonia, with elevated white blood cell and C-reactive protein levels, but normal eosinophil counts and IgE.
- Chest imaging revealed lung infiltrates unresponsive to antibiotic therapy.
Findings:
- Diagnosis of paragonimiasis was confirmed via immunoserology and detection of Paragonimus ova in sputum, stool, and bronchoalveolar lavage.
- Transbronchial lung biopsy showed eosinophilic infiltration and degranulation.
- Successful treatment with praziquantel resulted in complete clinical and radiological recovery.
Implications:
- This case highlights the importance of considering paragonimiasis in patients with persistent respiratory symptoms, even with atypical serological findings.
- The identification of Paragonimus westermani ova in Nagano prefecture represents a new geographical record.
- Early and accurate diagnosis of paragonimiasis is crucial for effective treatment and prevention of complications.