title: A rare case of paragonimiasis miyazakii with lung involvement diagnosed 7 years after infection: A case report and literature review.
abstract: We report a rare case of pulmonary paragonimiasis caused by Paragonimus miyazakii that showed pulmonary manifestations and a long-term clinical course after infection. A 45-year-old Japanese male developed cough and dyspnea in 2004 and was diagnosed with eosinophilic pneumonia. He had been treated with low-dose oral corticosteroid for 7 years. He recalled that he had consumed a large amount of raw freshwater crab (Geothelphusa dehaani) several weeks before he had been admitted for the first time, and that had been the only occasion when he had eaten this meat. The patient was referred to our hospital due to persistent hemoptysis, and his chest computed tomography scan showed pulmonary nodules and cavities, and his serum total IgE level was elevated. Bronchoscopy was performed, and ova were detected in the bronchoalveolar lavage fluid. The morphological examination of the ova and immunoserological examination yielded typical findings of P. miyazakii. Treatment with praziquantel improved his chest radiographic findings and a decrease of serum total IgE, as well as the values of immunoserological examination for P. miyazakii. The clinical course of this patient indicated that he had been infected with P. miyazakii for 7 years at least, which is unusual for paragonimiasis miyazakii.
authors.affiliation: Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka 807-8555, Japan. Electronic address: yatera@med.uoeh-u.ac.jp.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yatera
authors.affiliation: Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka 807-8555, Japan.
authors.forename: Minako
authors.initials: M
authors.lastname: Hanaka
authors.affiliation: Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka 807-8555, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Hanaka
authors.affiliation: Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka 807-8555, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Yamasaki
authors.affiliation: Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka 807-8555, Japan.
authors.forename: Chinatsu
authors.initials: C
authors.lastname: Nishida
authors.affiliation: Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka 807-8555, Japan.
authors.forename: Toshinori
authors.initials: T
authors.lastname: Kawanami
authors.affiliation: Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka 807-8555, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Kawanami
authors.affiliation: Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka 807-8555, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishimoto
authors.affiliation: Department of Immunology and Parasitology, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka 807-8555, Japan.
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Kanazawa
authors.affiliation: Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka 807-8555, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mukae
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use*; D003386:Brachyura / Q000469:parasitology*; D001992:Bronchoalveolar Lavage Fluid; D006801:Humans; D008174:Lung Diseases, Parasitic / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D010237:Paragonimiasis / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology; D010238:Paragonimus / Q000276:immunology* / Q000302:isolation & purification; D011223:Praziquantel / Q000627:therapeutic use*; D011657:Pulmonary Eosinophilia / Q000188:drug therapy; D012758:Shellfish / Q000469:parasitology*
chemical_list: D000305:Adrenal Cortex Hormones; D000871:Anthelmintics; D011223:Praziquantel
keywords: Bronchoalveolar lavage fluid; Corticosteroid; Eosinophilic pneumonia; Paragonimiasis; Paragonimus miyazakii; Paragonimus skrjabini