Pulmonary paragonimiasis is a food-borne parasitic disease caused by the lung fluke (trematode) Paragonimus westermani. It is endemic in southeast Asia, the Far East, and is also relatively common in Latin America and Africa 1,2. The disease can affect both the lung and pleura 3, although lung parenchymal involvement is thought to be commoner than pleural involvement 2.
CT chest: HRCT
It usually manifests as a poorly marginated subpleural or subfissural nodule of about 2 cm in diameter that frequently contains a necrotic low attenuation area 2. The constellation of focal pleural thickening and subpleural linear opacities leading to a necrotic peripheral pulmonary nodule is another frequent CT finding.
There are also a myriad of other associated non-specific features. These can vary with the stage of disease.
Early findings are thought to be caused by the migration of juvenile worms and include:
Later findings are thought to be caused by worm cysts and include:
- 1. Jeon K, Koh WJ, Kim H et-al. Clinical features of recently diagnosed pulmonary paragonimiasis in Korea. Chest. 2005;128 (3): 1423-30. doi:10.1378/chest.128.3.1423 - Pubmed citation
- 2. Kim TS, Han J, Shim SS et-al. Pleuropulmonary paragonimiasis: CT findings in 31 patients. AJR Am J Roentgenol. 2005;185 (3): 616-21. AJR Am J Roentgenol (citation) - Pubmed citation
- 3. Im JG, Whang HY, Kim WS et-al. Pleuropulmonary paragonimiasis: radiologic findings in 71 patients. AJR Am J Roentgenol. 1992;159 (1): 39-43. AJR Am J Roentgenol (citation) - Pubmed citation
- 4. Singcharoen T, Silprasert W. CT findings in pulmonary paragonimiasis. J Comput Assist Tomogr. 11 (6): 1101-2. - Pubmed citation
- 5. Mcmanus TE, Thomas M, Rogers D et-al. Pleuropulmonary paragonimiasis. Intern Med J. 2009;39 (3): 203. doi:10.1111/j.1445-5994.2008.01894.x - Pubmed citation
- 6. Kagawa FT. Pulmonary paragonimiasis. Semin Respir Infect. 1997;12 (2): 149-58. - Pubmed citation