気胸にて発症したウエステルマン肺吸虫症の1例  [in Japanese] A case of paragonimiasis Westermani with pneumothorax at onset  [in Japanese]

ウエステルマン肺吸虫症による気胸の1例を経験したので報告する.症例は76歳,男性.気胸の診断にて前医で胸腔ドレナージ施行され一旦は治癒したが,再発したため当科紹介となった.末梢血好酸球比率の上昇,好酸球性胸水を認め肺吸虫症を疑ったが,混濁した胸水と肺瘻の持続を認めたため胸腔鏡下手術を施行した.明らかな肺瘻部は不明であったが,膿苔の付着した肺を部分切除し気胸は改善した.術後,血清学的診断にて肺吸虫症と診断し,プラジカンテルの内服治療を行った.術後約8ヵ月を経過し再発を認めていない.

We report a rare case of paragonimiasis Westermani with pneumothorax at onset. A 76-year-old male was admitted to our hospital due to recurrent pneumothorax. Peripheral eosinophilia and eosinophilic pleural effusion were observed. In addition, he had eaten raw boar meat six months previously. Therefore, we suspected paragonimiasis. We performed VATS on the day following admission, because pleural effusion became purulent and air leakage was present. The clinical course was uneventful. The patient was diagnosed with paragonimiasis Westermani based on immunological examinations on the 10^<th> postoperative day, and was treated with praziquantel for 3 days. Paragonimiasis must be kept in mind in the differential diagnosis of pneumothorax cases with eosinophilia.