患儿，男，9岁，布依族，贵州籍学生，居住地存在并殖吸虫病流行，有饮用生水史和食生虾蟹史。2024年6月因“突发右侧肢体活动障碍”就诊于贵州医科大学第一附属医院，入院颅脑CT示左额顶叶脑出血，胸部CT见左肺下叶空洞，血常规示嗜酸粒细胞占比升高（18.40%），诊断为脑出血（病因不明），予丙戊酸钠口服液（20 ml/d）治疗3周后症状缓解。10月再发脑出血伴呕吐，二次入院，血常规示嗜酸粒细胞占比升高（18.10%），颅脑MRI增强见左额颞顶枕叶多发环形强化灶，胸部CT示肺部空洞迁移性改变，外周血ELISA检测结果示并殖吸虫抗体IgG阳性。确诊为脑胸型并殖吸虫病，予吡喹酮[75 mg/（kg•d），分3次口服，连用3 d × 2疗程，间隔1周]、地塞米松片（0.75 mg/d，口服）、丙戊酸钠口服液（20 ml/d，口服）治疗。出院后1个月随访，脑出血灶吸收，肺部病灶缩小，血清并殖吸虫抗体转阴；出院后6个月，患儿右侧肢体肌力恢复正常，未再发脑出血。

A 9-year-old Buyi boy, a student from Guizhou Province (a Paragonimus-endemic region), presented to the First Affiliated Hospital of Guizhou Medical University in June 2024 with sudden-onset right-sided limb weakness. His medical history was significant for chronic consumption of untreated water and raw crustaceans (shrimp and crabs). Initial cranial CT revealed left frontoparietal hemorrhage, while chest CT demonstrated a cavity in the left lower lung lobe. Laboratory tests showed marked eosinophilia (18.40%). Initially diagnosed as “intracerebral hemorrhage of unknown etiology”, he was treated with sodium valproate oral solution (20 ml/d) for 3 weeks, leading to symptomatic remission. In October, the patient was readmitted due to recurrent intracerebral hemorrhage with vomiting. Laboratory tests showed marked eosinophilia (18.10%). Enhanced brain MRI showed multiple ring-enhancing lesions in the left frontotemporoparietoccipital lobes, and chest CT revealed migratory pulmonary cavitations. Serological confirmation via peripheral blood ELISA showed positive Paragonimus IgG antibody, establishing the diagnosis of cerebro-thoracic paragonimiasis. Treatment consisted of praziquantel [75 mg/(kg·d) orally, divided into three doses daily for 3 days, repeated after a 1-week interval], dexamethasone tablets (0.75 mg/d orally), and continued sodium valproate (20 ml/d orally). At 1-month follow-up, imaging showed resolution of the intracerebral hemorrhage and reduction in pulmonary lesions, with seroconversion of Paragonimus antibody. Six months post-discharge, the child exhibited full recovery of right limb muscle strength without recurrent hemorrhage.