Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Pleuropulmonary paragonimiasis
- Radiologic Findings
- Chest PA view shows bronchial dilatation with small nodules in RLL and LUL. Chest CT shows tubular lucency/bronchiectasis with small nodules in LUL and small subpleural nodule in RLL. Tubular curvilinear lucency in LUL representing the worm burrow tract is shown.
- Brief Review
- Pleuropulmonary paragonimiasis is a parasitic disease caused by the Paragonimus westermani. This disease is caused by ingestion of a raw or incompletely cooked freshwater crab or crayfish infected with the metacercaria. Pulmonary lesions on chest PA and chest CT varies with the stage of the infection and the surrounding tissue reaction.The initial finding is patchy air-space consolidation due to hemorrhagic pneumonia caused by the migrating worm. At this stage, spontaneous pneumothorax or pleural effusion may be seen. As the juvenile worm matures into adult, cysts may form due to expansion of the small airway by the intraluminal parasite. Worm burrows or migration tracks can be seen a dilated bronchus or tubular lucency. The diagnosis of pleuropulmonary paragonimiasis is made either by detecting eggs in sputum, stool, fluid from bronchoscopic lavage or biopsy specimens, or by a positive anti-paragonimus antibody test. Distinguishing between paragonimiasis and tuberculosis may be difficult.
- References
- JG Im et al. Pleuropulmonary paragonimiasis: radiologic findings in 71 patients. AJR 1992;159:39-43
- Keywords
- Lung, Infection, Parasitic infection,