Allergy Asthma Respir Dis.  2020 Jan;8(1):36-39. 10.4168/aard.2020.8.1.36.

Identification of pulmonary paragonimiasis using Ziehl-Neelsen stain

• Kim WC
• Hahm CR
• Kim IT
• Koo JH
• Jung WJ

• KMID: 2469117
• DOI: http://doi.org/10.4168/aard.2020.8.1.36

Abstract

Pulmonary paragonimiasis and tuberculosis are endemic in Asia, South America, and Africa. However, differential diagnosis among the diseases is difficult because they present with similar clinical symptoms and diagnostic features. Here, we report a case of pulmonary paragonimiasis that was identified using Ziehl-Neelsen stain after initially being assessed for pulmonary tuberculosis. Following anti-Paragonimus chemotherapy, the patient's symptoms, laboratory test results, and lung lesions improved. Thus, the identification of Paragonimus westermani using Ziehl-Neelsen stain can be considered in the diagnosis.

Keyword

Pulmonary paragonimiasis; Pulmonary tuberculosis; Ziehl-Neelsen stain

MeSH Terms

Africa
Asia
Diagnosis
Diagnosis, Differential
Drug Therapy
Lung
Paragonimiasis*
Paragonimus westermani
South America
Tuberculosis
Tuberculosis, Pulmonary

Figure

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  Fig. 1 A sputum smear slide with Ziehl-Neelsen stain showed a reddish to brownish colored egg suspected of Paragonimus westermani. Magnification was 1,000× using oil immersion.

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  Fig. 2 (A) The initial chest X-ray in lateral decubitus position shows a significant amount of left pleural effusion (arrows). (B) Chest X-ray obtained 1 month later shows that the pleural effusion is resolved.

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  Fig. 3 Axial computed tomography (CT) scans reveal a focal area of consolidation containing tiny nodules in the upper left lobe (arrow) at the pulmonary window setting (A) and left pleural effusion (arrow) at the mediastinal window setting (C). (B, D) CT images obtained during the 3-month follow-up examination reveal improved lung lesions.

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