Korean Journal of Pediatrics 2008;51(7):760-765.
Published online July 15, 2008.
A case of subcutaneous paragonimiasis presented with pleural effusion
Soo Young Kim, Sun Ju Park, Si Young Bae, Young Kuk Cho, Chan Jong Kim, Young Jong Woo, Young Youn Choi, Jae Sook Ma, Tai Ju Hwang
Department of Pediatrics, Chonnam National University Medical School, Gwangju, Korea
흉수를 동반한 피하조직 이소기생 폐흡충증
김수영, 박선주, 배시영, 조영국, 김찬종, 우영종, 최영륜, 마재숙, 황태주
전남대학교 의과대학 소아과학교실
Correspondence: 
Jae Sook Ma, Email: youngcx@hanmail.net
Abstract
Paragonimiasis is a parasitic infection that occurs following the ingestion of infectious Paragonimus metacercariae from crabs or crayfish. Pulmonary paragonimiasis is the most common clinical manifestation of this infection, but several ectopic paragonimiasis cases have also been reported. Among them, cases of subcutaneous paragonimiasis are rare, especially in children. We report a case of subcutaneous paragonimiasis of the right abdominal wall with pleural effusion with hepatic involvement and without abnormal pulmonary infiltration in a boy aged 2 years and 5 months. He had eaten soybean sauce-soaked freshwater crabs (kejang) 6 months prior to complaining of right abdominal wall distension. On evaluation, right pleural effusion without abnormal pulmonary infiltration was detected, as well as blood eosinophilia, an elevated serum IgE level, pleural fluid eosinophilia and a positive enzyme-linked immunosorbent assay that detected P. westermani antibody in the serum. Thoracentesis, praziquantel administration, and excision of subcutaneous lesions were performed. After treatment, the eosinophil count and serum IgE level were decreased, and the subcutaneous lesions did not recur. The frequency of paragonimiasis has decreased recently, but it is still prevalent in Korea. Paragonimiasis should be suspected if pleural fluid eosinophilia is associated with blood hypereosinophilia and a high level of serum IgE; however clinicians should obtain a thorough history of travel and food habits.
Key Words: Subcutaneous paragonimiasis, Pleural effusion, Paragonimus westermani


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