skip to main content

Paragonimiasis — SCE Infectious Diseases MCQ

Instant feedback + full explanation. One question, done properly.

HardTropical & Imported InfectionsParagonimiasisSCE Infectious Diseases

A 35-year-old man presents with a 6-week history of cough, fever, and a single large thick-walled lung cavity on CT chest. He has recently returned from living in rural Thailand for 3 years. Sputum shows large barrel-shaped thick-walled ova. Eosinophil count is 4.8 × 10⁹/L. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Paragonimiasis (Paragonimus westermani)

Large thick-walled (operculated) ova in sputum with eosinophilia, lung cavitation, and residence in South-East Asia where raw freshwater crustaceans are consumed is classic for paragonimiasis. P. westermani (lung fluke) migrates through the gut wall to the pleural space and lung parenchyma, forming cystic cavities. Treatment is Praziquantel 25 mg/kg TDS for 3 days. Paragonimiasis is often misdiagnosed as TB due to similar clinical and radiological features.

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