- Several episodes of hematemesis in the last 6 months; cough developed in the last month; occasional labored breathing. No response to azithromycin; negative urine antigen Blastomyces test.
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- At least 3 nodular lesions in the lungs – with the nodule in the left cranial lobe appearing cavitated are noted on the thoracic radiographs.
- On the CT images there are multiple cavitated pulmonary lesions, mainly peribronchial. Most of these lesions are thick walled and contain non-enhancing material.
- Airway sampling revealed neutrophilic and eosinophilic inflammation.
- Sputum sample confirmed Paragonimus.
Progression of lesions – Paragonimus
- Pleural effusion, subpleural nodules +/- ground-glass opacities, linear opacities.
- Increased subpleural/peribronchial nodules, pleural effusion, pneumothorax, abdominal/chest wall air bubbles, early cavitary changes.
- Increased cavitary changes, mediastinal lymphadenopathy.
After Day 60
- Bronchial dilation
- Supleural groundglass opacities and subpleural nodules +/- cavitary cahnges consistently present until day 180.
Lee CH et al. Serial CT Findings of Paragonimus Infested Dogs and the Micro-CT Findings of the Worm Cysts. Korean J Radiol 2007;8:372 – 381.