case_images: PMC11804950_01
case_images: Section of an axial chest radiography. (a) At the time of diagnosis of chronic eosinophilic pneumonia. (b) One month following the start of corticosteroid therapy. (c) At the time of 10 mg/day of oral prednisolone therapy. (d) The left lung cavities worsened at 20 mg/day of oral prednisolone therapy. (e) Chest radiography showed deterioration of bilateral infiltrative shadow at 5 mg/day of oral prednisolone. (f) Oral prednisolone therapy was discontinued. (g) Three weeks following the start of praziquantel treatment. (h) Three months following the start of praziquantel treatment
case_images: ATM-20-74-g001.jpg
case_images: PMC11804950_01_ATM-20-74-g001.jpg
case_images: F1
case_images: Eight months before presentation, she visited another hospital with a cough and bloody sputum and underwent chest radiography, which revealed a bilateral infiltrative shadow [Figure 1a]. Seven months before presentation, chest radiography, and chest CT showed improvement in the bilateral infiltrative shadows [Figures 1b and 2a]. However, 5 months before presentation, the bilateral infiltrative shadow worsened and pulmonary cavities appeared at 10 mg/day of oral prednisolone therapy [Figures 1c and 2b], which was increased to 20 mg/day. One month before presentation, the left lung cavities worsened at 20 mg/day of oral prednisolone therapy [Figure 1d]; thus, transbronchial lung biopsy (TBLB) and BAL were repeated. C-reactive protein level (0.13 mg/dL). Chest radiography showed deterioration of the bilateral infiltrative shadows [Figure 1e]. Two weeks after the initial visit, her symptoms, such as cough and bloody sputum, worsened, and chest radiography revealed deterioration of the bilateral infiltrative shadow [Figure 1f]. Five weeks after the initial visit, follow-up chest radiography showed improvement in the bilateral infiltrative shadow [Figure 1g]. Moreover, follow-up chest radiography 3 months after treatment showed further improvement in the bilateral infiltrative shadows [Figure 1h].
case_images: Section of an axial chest computed tomography scan. (a) One month after starting corticosteroid therapy. (b) Bilateral infiltrative shadow worsened at 10 mg/day of oral prednisolone therapy
case_images: ATM-20-74-g002.jpg
case_images: PMC11804950_01_ATM-20-74-g002.jpg
case_images: F2
case_images: Seven months before presentation, chest radiography, and chest CT showed improvement in the bilateral infiltrative shadows [Figures 1b and 2a]. However, 5 months before presentation, the bilateral infiltrative shadow worsened and pulmonary cavities appeared at 10 mg/day of oral prednisolone therapy [Figures 1c and 2b], which was increased to 20 mg/day.
case_images: Paragonimus ova found in bronchoalveolar lavage; eggs are golden yellow (Papanicolaou, x100)
case_images: ATM-20-74-g003.jpg
case_images: PMC11804950_01_ATM-20-74-g003.jpg
case_images: F3
case_images: Although TBLB showed nonspecific findings, Paragonimus ova was found in the BAL fluid [Figure 3].