A Case of Delayed Diagnosis of Pulmonary Paragonimiasis due to Improvement after Anti-tuberculosis Therapy
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(Lee Suh-Yeon) - Seoul Medical Center Department of Internal Medicine
À¯¿¬½Ç(Yu Yeon-Sil) - Seoul Medical Center Department of Internal Medicine
¾ÈÁø¿µ(An Jin-Young) - Seoul Medical Center Department of Internal Medicine
ÀÌÁ¤¹Î(Lee Jeong-min) - Seoul Medical Center Department of Internal Medicine
¼ÕÁø¼º(Son Jin-Sung) - Seoul Medical Center Department of Thoracic and Cardiovascular Surgery
ÀÌ¿µ°æ(Lee Young-Kyung) - Seoul Medical Center Department of Radiology
¼Û¼÷Èñ(Song Sook-Hee) - Seoul Medical Center Department of Internal Medicine
±èÇý¿Á(Kim Hye-Ok) - Seoul Medical Center Department of Internal Medicine
±è¼öÇö(Kim Su-Hyun) - Seoul Medical Center Department of Internal Medicine
Abstract
Here, we report a case of pulmonary paragonimiasis that was improved with initial anti-tuberculosis (TB) therapy but confused with reactivated pulmonary TB. A 53-year-old Chinese female presented with a persistent productive cough with foul smelling phlegm and blood streaked sputum. Radiologic findings showed subpleural cavitary consolidation in the right upper lobe (RUL). Bronchoscopic and cytological examination showed no remarkable medical feature. She was diagnosed with smear-negative TB, and her radiologic findings improved after receiving a 6-month anti-TB therapy. The chest CT scans, however, obtained at 4 months after completion of anti-TB therapy showed a newly developed subpleural consolidation in the RUL. She refused pathologic confirmation and was re-treated with anti-TB medication. Nevertheless, her chest CT scans revealed newly developed cavitary nodules at 5 months after re-treatment. She underwent thoracoscopic wedge resection; the pathological examination reported that granuloma caused by Paragonimus westermani. Paragonimiasis should also be considered in patients assessed with smear-negative pulmonary TB.
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Paragonimus westermani, Tuberculosis
KMID :
0383820140770040178
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