A suspected case of Paragonimus westermani superinfection with Toxocara canis
Nobuo Ishiwataa Mitsue Hayashib Shun Tsuyukia Takafumi Suzukia Sahoko Chibaa Yasunari Miyazakib
aDepartment of Internal Medicine, Kudanzaka Hospital
bDepartment of Respiratory Medicine, Tokyo Medical and Dental University
A 45-year-old Thai woman presented at our hospital complaining of cough and pain from the upper abdomen to the right lateral chest over a period of three months. Chest CT scan showed left pleural effusion, small nodules in the right S6, and trabecular shadows in the left S4. Peripheral blood eosinophil count and serum IgE levels were elevated. Detailed history-taking revealed habitual consumption of half-raw freshwater crabs and raw pig liver. We suspected Paragonimus westermani. Double gel diffusion results showed the strongest precipitin bands between an extract from adult P. westermani and the patient's serum. In addition, strong precipitin bands were observed between larval Toxocara canis excretory-secretory products and the patient's serum. These results suggested P. westermani superinfection with T. canis. We diagnosed that the main infection was due to P. westermani, and she responded to praziquantel administration. Treatment for T. canis was not required. Considering lifestyle diversifications in recent years, it is important to be aware of infectious disease resulting from different eating habits.
Paragonimus westermani Toxocara canis Praziquantel Eating habit
Received 26 Apr 2021 / Accepted 18 Jun 2021
AJRS, 10(5): 393-397, 2021