患者，女，27岁，老挝人，有生食溪蟹史，近半年定居于安徽省芜湖市。2025年4月22日因反复咳嗽、咳痰1年就诊于皖南医学院第一附属医院。患者胸部CT示两肺感染性病变伴多发空洞形成、囊腔病变及两侧胸腔少量积液，血常规示嗜酸粒细胞绝对数（1.2 × 10⁹/L）和百分比（12.9％）均升高。取患者肺泡灌洗液送宏基因组二代测序（mNGS），检出异盘并殖吸虫序列数446条；取患者痰液行镜检，找到虫卵，明确诊断为肺部异盘并殖吸虫病。给予患者吡喹酮（口服，1 g/次，3次/d，连续3 d）抗寄生虫治疗，同时给予止咳化痰护理，患者咳嗽症状较前明显改善。15 d后复查嗜酸粒细胞比例3.4％。异盘并殖吸虫病国内报道甚少。此病例提示医务人员在面对常规治疗无效的慢性咳嗽患者时应考虑并殖吸虫病等寄生虫病的可能。

A 27-year-old female patient from Laos, with a history of consuming raw freshwater crabs, had been residing in Wuhu City, Anhui Province for the past six months. On April 22, 2025, she presented to the First Affiliated Hospital of Wannan Medical College with a one-year history of recurrent cough and expectoration. Her chest CT revealed infectious lesions in both lungs with multiple cavities, cystic changes, and a small amount of pleural effusion on both sides. The blood routine test showed elevated absolute eosinophil count (1.2 × 10⁹/L) and percentage (12.9%). Metagenomic next-generation sequencing (mNGS) performed on the patient’s bronchoalveolar lavage fluid detected 446 sequences of Paragonimus heterotremus. Eggs were identified upon microscopic examination of the patient’s sputum, leading to a definitive diagnosis of pulmonary P. heterotremus infection. The patient was treated with praziquantel (orally, 1 g per dose, three times daily for three consecutive days) as an antiparasitic therapy, along with cough-relieving and expectorant care. Her cough symptoms significantly improved compared to before, and follow-up examination revealed a reduction in the eosinophil percentage to 3.4%. Reports of P. heterotremus infection are rare in China. This case suggests that medical personnel should consider the possibility of parasitic diseases such as paragonimiasis when encountering patients with chronic cough that does not respond to conventional treatment.