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Paragonimiasis — SCE Infectious Diseases MCQ

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ModerateParasitologyParagonimiasisSCE Infectious Diseases

A 40-year-old woman from the Philippines presents with chronic cough and haemoptysis. Sputum examination shows golden-brown operculated eggs. She has a history of eating raw freshwater crabs. Chest X-ray shows cystic lesions in the right lower lobe. What is the most likely organism?

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Correct answer: A — Paragonimus westermani (lung fluke)

Golden-brown operculated eggs in sputum, chronic cough with haemoptysis, cystic lung lesions, and a history of eating raw freshwater crustaceans from an endemic area (Philippines, South-East Asia) is classic for paragonimiasis (Paragonimus westermani — the lung fluke). The cystic lesions can mimic TB radiologically. Treatment is Praziquantel 25 mg/kg TDS for 3 days. Triclabendazole is an alternative.

Reference: WHO 2022 – Trematode guidelines; UKHSA 2023 – Imported parasitic infections