Severe pleuropulmonary paragonimiasis 8 years after emigration from a region of endemicity

A Laotian man who had resided only in the north-central United States for 8 years sought care for an acute, progressive syndrome of severe dyspnea, chest pain, bilateral pneumothoraces, lung and liver nodules, and marked peripheral blood eosinophilia. He habitually ate raw crabmeat imported pickled or frozen from Southeast Asia; he denied eating local crustaceans. Ova consistent with the lung fluke Paragonimus westermani were identified in a bronchoalveolar lavage specimen, and the eosinophilia and pulmonary symptoms resolved with praziquantel therapy.