Rare case of pulmonary paragonimiasis in Jubail city
Abstract Introduction Paragonimiasis, a parasitic infection caused by Paragonimus westermani, is a rare but important differential diagnosis in patients presenting with cavitating lung lesions, especially those from endemic regions. Extrapulmonary involvement is uncommon and can pose significant dia...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2025-06-01
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| Series: | The Egyptian Journal of Bronchology |
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| Online Access: | https://doi.org/10.1186/s43168-025-00419-w |
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| author | Salah A. M. Ali Randa I. Ahmed Mohamed Deeb Mahmoud Hassan Nagwa Shahein Mohamed Hisham |
| author_facet | Salah A. M. Ali Randa I. Ahmed Mohamed Deeb Mahmoud Hassan Nagwa Shahein Mohamed Hisham |
| author_sort | Salah A. M. Ali |
| collection | DOAJ |
| description | Abstract Introduction Paragonimiasis, a parasitic infection caused by Paragonimus westermani, is a rare but important differential diagnosis in patients presenting with cavitating lung lesions, especially those from endemic regions. Extrapulmonary involvement is uncommon and can pose significant diagnostic challenges. Patient information A 41-year-old Filipino man, working as a driver, came to the emergency department with a 4-week history of shortness of breath, productive cough with yellowish sputum, fever, and body aches. He had a known history of poorly controlled type 2 diabetes for 4 years and was a heavy smoker. Clinical findings On examination, the patient appeared unwell with signs of hypoxemia and fever. Diagnostic assessment Initial investigation for multiple caviraty lesion were done like sputum for AFB. Given his background and travel history from an endemic area, parasitic infection was considered. A wet mount examination of fresh sputum revealed P. westermani ova, confirming the diagnosis. MRI scans of the brain and abdomen were unremarkable, but pelvic MRI revealed a scrotal abscess. The patient underwent surgical drainage of the abscess along with a left inguinal orchidectomy. Interestingly, Paragonimus ova were found in the abscess fluid, but no bacteria were cultured. Histopathology of the excised tissue showed intense inflammation involving the epididymis, spermatic cord, and surrounding tissues, with atrophic changes in the testicle—though no ova were seen in the histological samples. Therapeutic intervention He was started on praziquantel, the standard antiparasitic treatment, and recovered well following surgery. Follow-up and outcomes The patient showed noticeable clinical improvement after treatment. Conclusion This case underscores the importance of considering parasitic infections like P. westermani in patients with cavitary lung disease, particularly when typical causes are excluded. It also illustrates that extrapulmonary manifestations, though rare, can occur and may require surgical intervention. A high index of suspicion, especially in patients from endemic areas, can lead to timely diagnosis and effective management. This is the first case report of pulmonary paragonimiasis in Jubail and complicated by scrotal abscess worldwide. |
| format | Article |
| id | doaj-art-91480d253cb04025965eda04e7a4ef6f |
| institution | Kabale University |
| issn | 2314-8551 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Bronchology |
| spelling | doaj-art-91480d253cb04025965eda04e7a4ef6f2025-08-20T03:24:22ZengSpringerOpenThe Egyptian Journal of Bronchology2314-85512025-06-011911610.1186/s43168-025-00419-wRare case of pulmonary paragonimiasis in Jubail citySalah A. M. Ali0Randa I. Ahmed1Mohamed Deeb2Mahmoud Hassan3Nagwa Shahein4Mohamed Hisham5Department of PulmonologyDepartment of PulmonologyDepartment of Critical CareDepartment of UrologyDepartment of ParasitologyDepartment of RadiologyAbstract Introduction Paragonimiasis, a parasitic infection caused by Paragonimus westermani, is a rare but important differential diagnosis in patients presenting with cavitating lung lesions, especially those from endemic regions. Extrapulmonary involvement is uncommon and can pose significant diagnostic challenges. Patient information A 41-year-old Filipino man, working as a driver, came to the emergency department with a 4-week history of shortness of breath, productive cough with yellowish sputum, fever, and body aches. He had a known history of poorly controlled type 2 diabetes for 4 years and was a heavy smoker. Clinical findings On examination, the patient appeared unwell with signs of hypoxemia and fever. Diagnostic assessment Initial investigation for multiple caviraty lesion were done like sputum for AFB. Given his background and travel history from an endemic area, parasitic infection was considered. A wet mount examination of fresh sputum revealed P. westermani ova, confirming the diagnosis. MRI scans of the brain and abdomen were unremarkable, but pelvic MRI revealed a scrotal abscess. The patient underwent surgical drainage of the abscess along with a left inguinal orchidectomy. Interestingly, Paragonimus ova were found in the abscess fluid, but no bacteria were cultured. Histopathology of the excised tissue showed intense inflammation involving the epididymis, spermatic cord, and surrounding tissues, with atrophic changes in the testicle—though no ova were seen in the histological samples. Therapeutic intervention He was started on praziquantel, the standard antiparasitic treatment, and recovered well following surgery. Follow-up and outcomes The patient showed noticeable clinical improvement after treatment. Conclusion This case underscores the importance of considering parasitic infections like P. westermani in patients with cavitary lung disease, particularly when typical causes are excluded. It also illustrates that extrapulmonary manifestations, though rare, can occur and may require surgical intervention. A high index of suspicion, especially in patients from endemic areas, can lead to timely diagnosis and effective management. This is the first case report of pulmonary paragonimiasis in Jubail and complicated by scrotal abscess worldwide.https://doi.org/10.1186/s43168-025-00419-wParagonimus westermaniLungScrotal abscessJubail city |
| spellingShingle | Salah A. M. Ali Randa I. Ahmed Mohamed Deeb Mahmoud Hassan Nagwa Shahein Mohamed Hisham Rare case of pulmonary paragonimiasis in Jubail city The Egyptian Journal of Bronchology Paragonimus westermani Lung Scrotal abscess Jubail city |
| title | Rare case of pulmonary paragonimiasis in Jubail city |
| title_full | Rare case of pulmonary paragonimiasis in Jubail city |
| title_fullStr | Rare case of pulmonary paragonimiasis in Jubail city |
| title_full_unstemmed | Rare case of pulmonary paragonimiasis in Jubail city |
| title_short | Rare case of pulmonary paragonimiasis in Jubail city |
| title_sort | rare case of pulmonary paragonimiasis in jubail city |
| topic | Paragonimus westermani Lung Scrotal abscess Jubail city |
| url | https://doi.org/10.1186/s43168-025-00419-w |
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