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Abstract

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Article in Japanese

Diagnostic Imaging

A case of Paragonimus westermani infection with cavity expansion after treatment with praziquantel

Hanae Miyagawaa,b  Hideaki Nagaia  Shinobu Akagawaa  Kimihiko Masudaa  Atsuhisa Tamuraa  Ken Ohtaa 

aCenter for Pulmonary Disease, National Hospital Organization Tokyo National Hospital
bDepartment of Respiratory Medicine, The Jikei University Daisan Hospital

ABSTRACT

A 42-year-old Thai woman had a 1-year history of moving pain involving the entire body and a 1-month history of exacerbating right hypochondrial pain. Chest computed tomography showed multiple cavitary lesions and nodules in segment 6 of the right lung, and she was hospitalized on suspicion of pulmonary tuberculosis. However, she had a habit of eating raw meats, such as crab, frog, and others. Blood testing showed eosinophilia and elevation of serum IgE levels. Based on a positive reaction against Paragonimus westermani on microplate enzyme-linked immunosorbent assay (ELISA), P. westermani infection was diagnosed. Treatment with praziquantel proved effective, but the thin-walled cavitary lesions showed expansion after initiating treatment. Previous reports have described reduction or disappearance of cavities after treatment, but this case showed a different clinical course. Because left cavitary lesions have a possibility of chronic respiratory tract infection, careful follow-up should be required.

KEYWORDS

Paragonimus westermani  Cavity  Paragonimiasis 

Received 25 Feb 2016 / Accepted 21 Jul 2016

AJRS, 5(6): 356-360, 2016

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