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Paragonimus westermani infection manifesting as a pulmonary cavity and adrenal gland mass: A case report

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Affiliated Author(s)
권용식이혜원김현정
Alternative Author(s)
Kwon, Yong ShikLee, Hye WonKim, Hyun Jung
Journal Title
Journal of Infection and Chemotherapy
ISSN
1437-7780
Issued Date
2019
Keyword
ParagonimiasisParagonimus westermaniPulmonary parasitic infectionAdrenal glandPraziquantel
Abstract
We report a case of Paragonimus westermani infection simultaneously affecting two separate organs that presented as both a pulmonary cavity and adrenal mass in an immunocompromised host. A 65-year-old male with a previous kidney transplant visited our clinic because of hemoptysis. Chest computed tomography (CT) showed a pulmonary cavity and right adrenal gland mass. The Aspergillus antigen titer in bronchial lavage fluid was elevated and showed positive conversion. It was necessary to differentiate lung cancer with adrenal gland metastasis from a fungal infection with an adrenal gland adenoma. Positron emission tomography CT suggested benign disease, and it was misdiagnosed as pulmonary aspergillosis based on the elevated Aspergillus antigen titer in the bronchial lavage fluid. Owing to the adverse effects of anti-fungal treatment, the patient underwent wedge resection of the lung and P. westermani was confirmed. A careful history revealed that the patient had eaten raw freshwater crabs 3years earlier, and a test for serum antibodies to P. westermani was positive. Despite treatment with praziquantel, the adrenal mass persisted on 3-month follow-up CT. A right adrenalectomy was performed and a P. westermani infection was confirmed.
Department
Dept. of Internal Medicine (내과학)
Dept. of Pathology (병리학)
Publisher
School of Medicine (의과대학)
Citation
Yong Shik Kwon et al. (2019). Paragonimus westermani infection manifesting as a pulmonary cavity and adrenal gland mass: A case report. Journal of Infection and Chemotherapy, 25(3), 200–203. doi: 10.1016/j.jiac.2018.08.005
Type
Article
ISSN
1437-7780
DOI
10.1016/j.jiac.2018.08.005
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41775
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
1. School of Medicine (의과대학) > Dept. of Pathology (병리학)
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