2013 Volume 35 Issue 3 Pages 305-309
Background. Paragonimiasis is a parasitic disease caused by Paragonimus westermani, which is transmitted by the consumption of raw or undercooked freshwater crabs, such as Eriocheir japonica and Geothelphusa dehaani, or boar meat. Case. A 54-year-old woman was referred to our department because of left-sided pleural effusion. Fibrin deposits in the thoracic cavity were thoracoscopically removed under local anesthesia, followed by chest-tube drainage which led to resolution of the effusion, with no recurrence; however, the patient was referred to our department again 9 months later because of pleural effusion on the right side associated with a right pneumothorax. Peripheral blood examination revealed an increased eosinophil count and elevation of the serum IgE level, and chest CT revealed pleura-based nodules extending to the right upper and lower lobes. Parasite-specific antibody responses were examined based on the patient's history of habitual boar meat consumption, and Paragonimus westermani infection was diagnosed. Fibrin deposits in the thoracic cavity were thoracoscopically removed under local anesthesia, followed by drainage of the pleural effusion and oral administration of praziquantel, an antiparasitic drug. There was no recurrence of the pleural effusion, and the parasite-specific antibody titers also decreased following treatment. Conclusion. The condition in this patient was thought to be caused by migration of the parasite from the initial location in the left lung to the right thoracic cavity.
