A Case of Delayed Diagnosis of Pulmonary Paragonimiasis due to Improvement after Anti-tuberculosis Therapy.
10.4046/trd.2014.77.4.178
- Author:
Suhyeon LEE
1
;
Yeonsil YU
;
Jinyoung AN
;
Jeongmin LEE
;
Jin Sung SON
;
Young Kyung LEE
;
Sookhee SONG
;
Hyeok KIM
;
Suhyun KIM
Author Information
1. Department of Internal Medicine, Seoul Medical Center, Seoul, Korea. sammy7597@naver.com
- Publication Type:Case Report
- Keywords:
Paragonimus westermani;
Tuberculosis
- MeSH:
Asian Continental Ancestry Group;
Cough;
Delayed Diagnosis*;
Female;
Granuloma;
Humans;
Middle Aged;
Paragonimiasis*;
Paragonimus westermani;
Smell;
Sputum;
Tomography, X-Ray Computed;
Tuberculosis
- From:Tuberculosis and Respiratory Diseases
2014;77(4):178-183
- CountryRepublic of Korea
- Language:English
-
Abstract:
Here, we report a case of pulmonary paragonimiasis that was improved with initial anti-tuberculosis (TB) therapy but confused with reactivated pulmonary TB. A 53-year-old Chinese female presented with a persistent productive cough with foul smelling phlegm and blood streaked sputum. Radiologic findings showed subpleural cavitary consolidation in the right upper lobe (RUL). Bronchoscopic and cytological examination showed no remarkable medical feature. She was diagnosed with smear-negative TB, and her radiologic findings improved after receiving a 6-month anti-TB therapy. The chest CT scans, however, obtained at 4 months after completion of anti-TB therapy showed a newly developed subpleural consolidation in the RUL. She refused pathologic confirmation and was re-treated with anti-TB medication. Nevertheless, her chest CT scans revealed newly developed cavitary nodules at 5 months after re-treatment. She underwent thoracoscopic wedge resection; the pathological examination reported that granuloma caused by Paragonimus westermani. Paragonimiasis should also be considered in patients assessed with smear-negative pulmonary TB.
