A case of Paragonimiasis with Bilateral Pneumothorax in a Chinese man

A 52-year-old Chinese man who was a cook by occupation visited our emergency department complaining of left-sided chest pain, and was diagnosed as having left-sided hydropneumothorax by chest computed tomography. The hydropneumothorax resolved with chest drainage, but subsequently, he presented twice within a month with recurrent right hydropneumothorax. We suspected paragonimiasis, but failed to detect any parasite ova in either the feces or the pleural fluid, and finally confirmed the diagnosis of paragonimiasis by serology. On further history-taking, the patient admitted to having eaten raw mitten crabs. Paragonimiasis is often difficult to diagnose, and detailed history-taking and proactive testing are important.