Spontaneous Pneumothorax Secondary to Pulmonary Paragonimiasis: A Case Report Highlighting Diagnostic Delay in Eastern Nepal

• Published in: Respirology Case Reports
• Main Authors: Arun Kumar Mahato, Sonu Shah, Sandip Kumar Sah, K. C. Rupak, Bigyan Adhikari, Ashit Pokhrel
• Format: Article
• Language: English
• Published: Wiley 2025-03-01
• Subjects: freshwater snail; hypereosinophilia; Paragonimus westermani; praziquantel; spontaneous pneumothorax
• Online Access: https://doi.org/10.1002/rcr2.70131

ABSTRACT Paragonimiasis, or oriental lung fluke, a zoonotic disease acquired by consuming raw or undercooked crustaceans such as crabs or snails, can mimic tuberculosis in endemic regions. There is a wide range of clinical symptoms depending on the parasite location, from non‐specific symptoms like diarrhoea, abdominal pain, rash, and fever to pleuropulmonary symptoms like cough, haemoptysis, chest pain, and dyspnoea. Pneumothorax is the rare clinical picture. We present a case of a 48‐year‐old male non‐smoker with a persistent cough for 3 months and who was treated for acute eosinophilic pneumonia initially at another centre. He then presented with symptoms of spontaneous pneumothorax at our centre and was treated with a chest tube. Revisiting the history, raw snail consumption was noted. Microscopic examination of a wet mount bronchoalveolar lavage (BAL) confirmed the diagnosis of Paragonimus westermani, and praziquantel was started; he improved significantly within 48 h.