2012 Volume 34 Issue 6 Pages 552-557
Cases. Case 1: A 69-year-old man was referred to our hospital with left pleural effusion. Eosinophilia in peripheral blood and pleural effusion were identified. The effusion was exudative with low pH, low glucose and high lactate dehydrogenase (LDH) levels. Case 2: A 69-year-old man was admitted to our hospital with abdominal pain. Chest CT showed a mass shadow in the right upper lobe and right pleural effusion. He had eosinophilia, but the eosinophil fraction of his pleural effusion was 7%. The effusion was exudative with low pH, low glucose and high LDH levels. Analysis of a transbronchial lung biopsy specimen of the mass lesion revealed prominent eosinophilic infiltration. In both the cases, they had histories of eating raw boar meat, and Paragonimus westermani-specific IgG antibody titers were extremely high in their serum. Thus, P. westermani infection was diagnosed. After oral administration of praziquantel, their chest CT and eosinophilia were improved. Conclusion. P. westermani is a parasite of freshwater crabs, and consumption of inadequately cooked crabs causes infection with this parasite. Wild boars are paratenic hosts of P. westermani and the infection in humans is also caused by eating raw or improperly cooked boar meat. Pulmonary infiltration with eosinophilia in the peripheral blood and pleural effusion, abdominal pain, and history of eating raw boar meat suggest P. westermani infection.