We have diagnosed four cases of Paragonimiasis, one of them was a patient who had suffered since 2 years, done all investigation including bone marrow, spend 2 lakhs, visited different hospital of Nepal from Gulmi-palpa-butwal-bharatpur and finally to Kathmandu (TUTH) and have taken anti-tubercular drug despite all investigation negative for tuberculosis due his sign and symptoms ( like fever , respiratory distress, chest pain with pleural and pericardial effusion) with no improvement. He has hyper-eosinophilia and had history of consumption of raw minced crab to cure his jaundice (in remote villages of Nepal there is local believe that eating raw crab helps to cure jaundice). After two years of suffering, lots of expenditure and visiting different hospital from different part of country, he came to TU Teaching Hospital in Respiratory OPD, from there he was referred to our hematologist and he called me to look for all possible parasites. Finally, the diagnosis was made by demonstrating ova of Paragonimus in sputum sample and photographic evidence was forwarded to CDC (Centers of Disease Control and Prevention). They have confirmed as Ova of Paragonimus species and on the basis of geographical distribution as Ova of Paragonimus westermani.  Patient was treated with praziquantel 1800mg (600mg x 3 tab) twice daily for seven days and  he got improved with reduction of his peripheral eosinophil count with in normal range.

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Ova of Paragonimus species

 

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Ova of Paragonimus species

 

 

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Measurement of the ova (77μm by 50 μm) using cell sensation software version 1.12 for DP73 camera installed to the Olympus BX53 microscope used for the microscopy

 

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