Abstract:

A 13-year-old boy, a student from Jianhe County, Guizhou Province, was admitted to the People’s Hospital of Qiandongnan Miao and Dong Autonomous Prefecture on September 15, 2023, due to “repeated coughing for more than 20 days”. On August 26, 2023, he was diagnosed with "pleural effusion and community-acquired pneumonia" at an external hospital and received pleural effusion drainage and medication, which improved his condition. The chest CT scan showed a small amount of pleural effusion. Physical examination revealed a subcutaneous mass around the navel with skin itching. Laboratory tests revealed an elevated eosinophil count (2.28 × 10⁹/L), eosinophil percentage (20.1%), and serum total IgE antibodies (1 101.77 IU/ml). IgG antibodies against Paragonimus, Clonorchis sinensis, and Sparganum were all positive. The epidemiological investigation results showed that the child had a history of eating snake meat and drinking unboiled water. Therefore, a diagnosis of parasitic infection with a high possibility of Paragonimus infection was made. After two courses of oral praziquantel treatment (1.2 g, three times daily, for 5 days and then 3 days), the child’s cough, subcutaneous mass around the navel, and skin itching were significantly relieved, and the eosinophil count returned to normal. He was discharged on September 26, 2023. After 4 months, a follow-up showed slight encapsulated pleural effusion with mild pleural thickening. The pleural effusion resolved after 10 months of follow-up.

Key words: Paragonimus, Clonorchis sinensis, Sparganum, Pleural effusions, Subcutaneous mass, Adolescents