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Paragonimiasis Treatment — SCE Infectious Diseases MCQ

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EasyParasitologyParagonimiasis TreatmentSCE Infectious Diseases

A 35-year-old man from the Philippines presents with chronic productive cough and haemoptysis. Sputum microscopy shows large operculated eggs (80–120 µm) that are yellowish-brown. He reports eating raw freshwater crabs. Chest X-ray shows bilateral lower lobe cystic lesions. What is the treatment?

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Correct answer: D — Praziquantel 25 mg/kg TDS for 3 days

Large operculated eggs (80–120 µm) in sputum from a patient who ate raw freshwater crustaceans in endemic area is diagnostic of paragonimiasis (Paragonimus westermani — lung fluke). Praziquantel 25 mg/kg TDS for 3 days is the treatment of choice with cure rates >95%. Triclabendazole (used for Fasciola) is an alternative. Paragonimiasis can mimic TB radiologically (cavitation, nodules, pleural effusion) — misdiagnosis as TB is common in endemic areas.

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