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Cho, Lim, Chae, Chi, Ban, Yoon, Kwon, Oh, Kim, Kim, Lim, and Kim: A Case of Pulmonary Paragonimiasis with Recurrent Pleural Effusion and Cured by Four Cycles of Chemotherapy
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2009; 66(6): 451-456.

Published online: 30 June 2009

DOI: https://doi.org/10.4046/trd.2009.66.6.451

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

Gye Jung Cho, M.D.1, Jung Hwan Lim, M.D.2, Dong Ryeol Chae, M.D.2, Su Young Chi, M.D.3, Hee Jung Ban, M.D.3, Byeong Kab Yoon, M.D.3, Yong Soo Kwon, M.D.3, In Jae Oh, M.D.3, Kyu Sik Kim, M.D.3, Yu Il Kim, M.D.3, Sung Chul Lim, M.D.3, Young Chul Kim, M.D.3

1Department of Internal Medicine, Yeoung Gwang General Hospital, Yeounggwang, Korea.

2Department of Internal Medicine, Stcarollo Hospital, Suncheon, Korea.

3Division of Pulmonary and Critical Care Medicine, Chonnam National University Medical School, Gwangju, Korea.

Address for correspondence: Yu Il Kim, M.D. Department of Internal Medicine, Division of Pulmonology and Critical Care Medicine, Chonnam National University Medical School and Hospital, 8, Hak-dong, Dong-gu, Gwangju 501-757, Korea. Phone: 82-62-220-6296, Fax: 82-62-225-8578, kyionly@chonnam.ac.kr

Received 10 May 2009       Accepted 25 May 2009

Copyright©2009. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

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.

Keywords: Paragonimiasis, Recurrence, Praziquantel

Figures and Tables

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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Table 1
Clinical course and laboratory finding
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enzyme-linked immunosorbent assay

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