Tuberc Respir Dis.  2009 Jun;66(6):451-456.

A Case of Pulmonary Paragonimiasis with Recurrent Pleural Effusion and Cured by Four Cycles of Chemotherapy

• Cho GJ
• Lim JH
• Chae DR
• Chi SY
• Ban HJ
• Yoon BK
• Kwon YS
• Oh IJ
• Kim KS
• Kim YI
• Lim SC
• Kim YC

Abstract

Paragonimiasis is a parasitic infection that occurs following the ingestion of infectious Paragonimus metacercariae, which occurs as a result of eating raw or undercooked freshwater crabs or crayfish. Pulmonary paragonimiasis is the most common clinical manifestation of this infection. Human paragonimiasis occurs sporadically. We experienced a case of pulmonary paragonimiasis in a 35-year-old woman with left lower chest pain. The patient had hypereosinophilia and a pleural effusion. The diagnosis was confirmed by positive ELISA (Enzyme-linked immunosorbent assay) that detected Paragonimiasis westermani antibody in the serum. We treated the patient with praziquantel for two days at a daily dosage of 75 mg/kg. Left pleuritic pain and pleural effusion improved after treatment. However, similar symptoms and pleural effusion developed recurrently for the first 3 courses of treatment with praziquantel. Upon the fourth round of treatment, the patient made a full recovery.

Keyword

Paragonimiasis; Recurrence; Praziquantel

MeSH Terms

Adult
Astacoidea
Chest Pain
Eating
Enzyme-Linked Immunosorbent Assay
Female
Fresh Water
Humans
Metacercariae
Paragonimiasis
Paragonimus
Pleural Effusion
Praziquantel
Recurrence
Praziquantel

Figure

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  Figure 1 (A) Chest PA on admission shows left pleural effusion. (B) Chest CT on admission demonstrates pleural effusion in the left lower lung.

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  Figure 2 Chest PA after first cycle praziquantel medication shows decreased left pleural effusion.

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  Figure 3 Chest X-ray on first recurrence of paragonimiasis shows increased left pleural effusion.

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  Figure 4 Chest X-ray after four cycle chemotherapy of paragonimiasis shows remission of left pleural effusion.

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