Paragonimiasis Misdiagnosed as Pulmonary Tuberculosis: A Case Report

Abstract

Paragonimiasis is a zoonosis caused by the ingestion of raw or undercooked crustaceans parasitized with metacercaria of Paragonimus spp. In Peru, Cajamarca is considered an endemic region for paragonimiasis. A 29-year-old man from the department of San Martín, Peru presented with a three-year history of cough, chest pain, fever, and hemoptysis. Treatment for tuberculosis (TB) was initiated even with negative results for sputum acid-fast bacillus (AFB), due to the patient's clinical characteristics and the high prevalence of the condition in the region. After eight months, due to the lack of any clinical improvement, he was referred to a regional hospital, where Paragonimus eggs were evidenced in direct sputum cytology. The patient received treatment with triclabendazole and showed clinical and radiological improvement. It is important to consider eating habits, even in non-endemic areas, for diagnosing paragonimiasis in patients with TB symptoms who do not respond to a specific treatment.

Peripheral blood eosinophils: an important reference for radiologists to distinguish between pulmonary paragonimiasis and tuberculous pleurisy in children

“…Clinically, pulmonary paragonimiasis is difficult to distinguish from active pulmonary tuberculosis due to the presence of cough, sputum production, fever, and pleural effusion [ 2 ]. On CT images, pulmonary paragonimiasis can manifest as pleural effusion as well as pulmonary nodules, strip-shaped, and with patchy consolidation, and is frequently misdiagnosed as tuberculosis and other diseases [ 2 , 3 ]. When paragonimiasis is misdiagnosed as tuberculosis, patients are treated with anti-tuberculosis drugs, which not only prolong the condition of the patient but may also cause adverse drug reactions.…”