Paragonimiasis diagnosed and treated by video assisted thoracoscopic surgery

Abstract

We report a case of paragonimiasis diagnosed and treated by video assisted thoracoscopic surgery (VATS). The patient was 41-year-old man in whom left pleural effusion was revealed by medical examination, without subjective symptoms. A computed tomographic scan of the chest did not reveal any lesion in the lung field. Although he had not eaten any uncooked fresh geothelphusa dehaani or wild boar meat, eosinophilia of the peripheral blood and the pleural effusion suggested paragonimiasis. We performed VATS to observe the pleural cavity and observed an elevated lesion at the posterior wall of the pleural cavity just above the diaphragm. Pathological examination of a resected specimen revealed granulation tissue with marked eosinophilic infiltration, although no organisms (paragonimus) were identified. Dot ELISA (enzyme linked immuno sorbent assay) tests yielded a conclusive diagnosis of paragonimus infection. After surgery, we administered 75 mg/m² of praziquantel for three days. And in the period since surgery, three months, the patient has not shown any clinical symptoms, and his antibody titer of paragonimus has been decreasing. VATS is considered to be useful in the diagnosis and treatment of Paragonimiasis.