Identification of pulmonary paragonimiasis using Ziehl-Neelsen stain

Won Chul Kim; Cho Rom Hahm; Il Tae Kim; Jin Hoi Koo; Woo Jin Jung

doi:10.4168/aard.2020.8.1.36

Journal List > Allergy Asthma Respir Dis > v.8(1) > 1141945

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Kim, Hahm, Kim, Koo, and Jung: Identification of pulmonary paragonimiasis using Ziehl-Neelsen stain

Case Report

Allergy, Asthma & Respiratory Disease 2020; 8(1): 36-39.

Published online: 31 January 2020

DOI: https://doi.org/10.4168/aard.2020.8.1.36

Identification of pulmonary paragonimiasis using Ziehl-Neelsen stain

Won Chul Kim¹, Cho Rom Hahm¹, Il Tae Kim², Jin Hoi Koo³, Woo Jin Jung¹

¹Department of Medicine, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea.

²Department of Laboratory Medicine, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea.

³Department of Radiology, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea.

Correspondence to: Woo Jin Jung. Division of Pulmonary Medicine, Department of Medicine, Gwangmyeong Sungae Hospital, 36 Digital-ro, Gwangmyeong 14241, Korea. Tel: +82-2-2680-7114, Fax: +82-2-2680-7755, us2001wj@naver.com

Received 7 August 2018 Revised 18 September 2018 Accepted 1 October 2018

The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma, Allergy and Clinical Immunology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/).

Abstract

Pulmonary paragonimiasis and tuberculosis are endemic in Asia, South America, and Africa. However, differential diagnosis among the diseases is difficult because they present with similar clinical symptoms and diagnostic features. Here, we report a case of pulmonary paragonimiasis that was identified using Ziehl-Neelsen stain after initially being assessed for pulmonary tuberculosis. Following anti-Paragonimus chemotherapy, the patient's symptoms, laboratory test results, and lung lesions improved. Thus, the identification of Paragonimus westermani using Ziehl-Neelsen stain can be considered in the diagnosis.

Keywords: Pulmonary paragonimiasis, Pulmonary tuberculosis, Ziehl-Neelsen stain

Figures and Tables

Fig. 1

A sputum smear slide with Ziehl-Neelsen stain showed a reddish to brownish colored egg suspected of Paragonimus westermani. Magnification was 1,000× using oil immersion.

Fig. 2

(A) The initial chest X-ray in lateral decubitus position shows a significant amount of left pleural effusion (arrows). (B) Chest X-ray obtained 1 month later shows that the pleural effusion is resolved.

Fig. 3

Axial computed tomography (CT) scans reveal a focal area of consolidation containing tiny nodules in the upper left lobe (arrow) at the pulmonary window setting (A) and left pleural effusion (arrow) at the mediastinal window setting (C). (B, D) CT images obtained during the 3-month follow-up examination reveal improved lung lesions.

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ORCID iDs: Woo Jin Jung
https://orcid.org/0000-0003-4519-1042
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