A case of spontaneous pneumothorax due to paragonimiasis in North America with literature review
Seung Ah Kang,
Parag Kumar Patel,
Sachin Patil,
Andres Bran-Acevedo,
Lester Layfield,
Sebastian Wiesemann,
William Roland
Affiliations
Seung Ah Kang
M4 Medical student, University of Missouri School of Medicine, Columbia, USA; University of Missouri Hospital and clinic, 1 Hospital Dr, Columbia, MO 65212, USA
Parag Kumar Patel
Department of Medicine, Division of Infectious Diseases, University of Missouri, Columbia, USA; University of Missouri Hospital and clinic, 1 Hospital Dr, Columbia, MO 65212, USA
Sachin Patil
Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Missouri, Columbia, USA; University of Missouri Hospital and clinic, 1 Hospital Dr, Columbia, MO 65212, USA; Correspondence to: Division of Pulmonary, Critical Care and Environmental Medicine, USA.
Andres Bran-Acevedo
Department of Medicine, Division of Infectious Diseases, University of Missouri, Columbia, USA; University of Missouri Hospital and clinic, 1 Hospital Dr, Columbia, MO 65212, USA
Lester Layfield
Department of Pathology and Anatomical Sciences, University of Missouri, Columbia, USA; University of Missouri Hospital and clinic, 1 Hospital Dr, Columbia, MO 65212, USA
Sebastian Wiesemann
Department of Cardiothoracic Surgery, University of Missouri, Columbia, USA; University of Missouri Hospital and clinic, 1 Hospital Dr, Columbia, MO 65212, USA
William Roland
Department of Medicine, Division of Infectious Diseases, University of Missouri, Columbia, USA; University of Missouri Hospital and clinic, 1 Hospital Dr, Columbia, MO 65212, USA
The species, Paragonimus kellicotti , causes human paragonimiasis in North America. As a foodborne disease, human infection with P. kellicotti occurs after eating raw or undercooked crayfish containing metacercariae. Many risk factors have been described in the literature, including young adult age, male, alcohol consumption, outdoor activities involving rivers within Missouri, and ingesting raw or partially cooked crayfish. Here, we report a case of a 41-year-old male with a 5-year history of cough who presented with acute shortness of breath. Further workup showed mild eosinophilia and spontaneous pneumothorax. A definitive diagnosis was made with a lung biopsy, which showed P. kellicotti eggs. Further questioning revealed that the patient took a hunting and river rafting trip on a river in Missouri 5 years ago, though the history was negative for any crayfish consumption. Paragonimiasis should be considered in those with associated clinical features, including cough and eosinophilia, with a history of a river raft float trip in Missouri, even if the history is negative for crayfish ingestion or travel.
