Unilateral Massive Pleural Effusion Mimicking Pulmonary Tuberculosis Due To Pleuropulmonary Paragonimiasis- A Case from Manipur, India

Paragonimiasis is a food-borne zoonotic disease caused by the genus Paragonimus which usually results from the intake of uncooked or undercooked freshwater crab or crayfish. Manipur is a northeastern state of India which is endemic for paragonimiasis where the first Indo-Japan joint research on Paragonimus and paragonimiasis was conducted to study the life cycle, pathobiology, and morphological characterization of Paragonimus species in India. Diagnosis of paragonimiasis is often difficult due to lack of awareness and atypical presentation which usually mimic other chronic pulmonary illness such as tuberculosis. Diagnosis of paragonimiasis is by detection of ova in the sputum,pleural fluid or tissue specimen or serology. The disease can be successfully treated by praziquantel. Here we report a case of pulmonary paragonimiasis presented as right sided massive eosinophilic pleural effusion from an area endemic for paragonimiasis which was initially mistaken as smear negative pulmonary tuberculosis.