A case of eosinophilic pleural effusion who was serologically positive for both Paragonimus westermani and Toxocara canis / 대한내과학회지

ABSTRACT

A 36-year-old women visited hospital with right pleuritic chest pain. Chest X-ray showed right pleural effusion. Hematological examination revealed eosinophilia in peripheral blood (28%) and pleural effusion (90%). ELISA (enzyme-linked immunosorbent assay) for serum parasite-specific IgG antibody was negative. We examined HRCT and thoracoscopic pleural biopsy, but didn't find out the cause of pleural effusion. We found out Toxocara canis excretory-secretory IgE ELISA was positive. One month later, multiple nodular shadows appeared in left upper lung field. We reexamined ELISA for serum Paragonimus westermani IgG antibody, and the result was positive. She was treated with praziquantel for 2 days, and then the lung lesions and pleuritic chest pain disappeared. We report here P. westermani infection in a patient whose serum was negative for the specific IgG antibody by ELISA at earlier stage but became positive later, and whose serum was also positive for Toxocara canis.