Pleural Paragonimiasis

A 17-year-old boy from El Salvador was diagnosed with pleural paragonimiasis after a routine chest radiograph at an immigration clinic revealed a pleural effusion. Despite being asymptomatic, further imaging detected a small lung nodule and laboratory tests showed eosinophilia (13% of nucleated cells in pleural fluid, reference <10%).

Parasite eggs were identified in the pleural fluid, and targeted 28S ribosomal RNA sequencing confirmed Paragonimus mexicanus. The patient recalled eating undercooked crustaceans two years earlier, supporting parasite exposure. Testing for tuberculosis was negative, ruling out other differential diagnoses.

Paragonimiasis is caused by lung fluke infection, often asymptomatic but typically presenting with pulmonary symptoms. While P. westermani is more common in Asia, P. mexicanus is found in Central and South America. The patient was treated with praziquantel, and at a four-month follow-up, the pleural effusion showed minimal improvement

A 17-year-old boy from El Salvador was diagnosed with pleural paragonimiasis after a routine chest radiograph at an immigration clinic revealed a pleural effusion. Despite being asymptomatic, further imaging detected a small lung nodule and laboratory tests showed eosinophilia (13% of nucleated cells in pleural fluid, reference <10%).

Parasite eggs were identified in the pleural fluid, and targeted 28S ribosomal RNA sequencing confirmed Paragonimus mexicanus. The patient recalled eating undercooked crustaceans two years earlier, supporting parasite exposure. Testing for tuberculosis was negative, ruling out other differential diagnoses.

Paragonimiasis is caused by lung fluke infection, often asymptomatic but typically presenting with pulmonary symptoms. While P. westermani is more common in Asia, P. mexicanus is found in Central and South America. The patient was treated with praziquantel, and at a four-month follow-up, the pleural effusion showed minimal improvement