Which parasite is a lung-dwelling fluke that can be misdiagnosed as tuberculosis due to pulmonary symptoms?

Which parasite is a lung-dwelling fluke that can be misdiagnosed as tuberculosis due to pulmonary symptoms?

• A. Paragonimus westermani
• B. Schistosoma mansoni
• C. Opisthorchis viverrini
• D. Clonorchis sinensis

Answer: (A)

Paragonimus westermani is a lung-dwelling fluke that causes paragonimiasis. It migrates to the lungs after ingestion of undercooked freshwater crustaceans (like crabs or crayfish), leading to chronic cough, chest pain, and often hemoptysis. The pulmonary symptoms and radiographic findings can resemble tuberculosis, which is why this parasite is the classic cause of TB-like lung disease. Eggs may be found in sputum or stool, and imaging can show infiltrates or nodules in the lungs. The other options are liver- or intestinal-flukes and do not characteristically inhabit the lungs or produce the same TB-like pulmonary presentation: Schistosoma mansoni primarily affects the intestines and liver; Opisthorchis viverrini and Clonorchis sinensis infect the biliary ducts and cause biliary disease rather than lung symptoms.

Paragonimus westermani is a lung-dwelling fluke that causes paragonimiasis. It migrates to the lungs after ingestion of undercooked freshwater crustaceans (like crabs or crayfish), leading to chronic cough, chest pain, and often hemoptysis. The pulmonary symptoms and radiographic findings can resemble tuberculosis, which is why this parasite is the classic cause of TB-like lung disease. Eggs may be found in sputum or stool, and imaging can show infiltrates or nodules in the lungs.

The other options are liver- or intestinal-flukes and do not characteristically inhabit the lungs or produce the same TB-like pulmonary presentation: Schistosoma mansoni primarily affects the intestines and liver; Opisthorchis viverrini and Clonorchis sinensis infect the biliary ducts and cause biliary disease rather than lung symptoms.