Pulmonary nodules
A 35 year old woman presented with right sided pleuritic chest pain since 1 year. She did not report weight loss, cough, or hemoptysis. She had migrated from Bihar 2 years previously. Her spouse was a construction worker; she had 2 children and she reported no history of tuberculosis or recent exposure. A chest radiograph was normal. Hemogram and ESR were normal. Sputum acid-fast stains and GeneXpert MTB RIF were negative. There was no clinical response to empirical ATT started 2 months earlier.
Sputum examination for Paragonimus eggs was negative. The patient was administered praziquantel 1200 mg TDS for 2 days. She reported significant improvement of symptoms over the next week. A CT chest obtained 1 month later showed almost-complete regression of pulmonary nodules. At followup after 6 months patient remained asymptomatic.
Possible Pulmonary Paragonimiasis