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Korean J Parasitol > Volume 20(1):1982 > Article

Case Report
Korean J Parasitol. 1982 Jun;20(1):53-59. English.
Published online Mar 20, 1994.  http://dx.doi.org/10.3347/kjp.1982.20.1.53
Copyright © 1982 by The Korean Society for Parasitology
A case of systemic paragonimiasis with ovarian involvement
Sung-Tae Hong,*Soon-Hyung Lee,*Je-Geun Chi,**Young-Soo Jin,***Chung-Soo Kim,*** and Yoon-Seok Chang***
*Department of Parasitology, College of Medicine, Seoul National University, Korea.
**Department of Pathology, College of Medicine, Seoul National University, Korea.
***Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Korea.

The authors reported a case of ectopic paragonimiasis in a 40 year old Korean housewife who came to the hospital because of abdominal mass and pain. She was proved to have multiple parasitic granulomas involving lung, uterus, uterine tube and subcutaneous tissue. The ovary was also the site of parasitism. The past history revealed an episode of ingestion of fresh water crabs soaked in soybean sauce which were obtained in a market of Seoul City 2 years prior to the present illness. The patient was treated for tuberculosis for a year without confirmation of etiologic agent. After surgical removal of all abdominal and most of pelvic granulomas, the patient was treated with praziquantel 25 mg/kg t.i.d. for 3 days, and was judged to be cured after 4 months.


Figs. 1-4
Fig. 1. Chest P-A film before chemotherapy; white arrow indicates a nodule in right upper lung field.

Fig. 2 & 3. Chest P-A films, taken 2 and 4 months after chemotherapy. White arrows indicate changed nodular density.

Fig. 4. Intravenous pyelography showing right hydronephrosis and hydroureter.

Figs. 5-8
Fig. 5. Low power view(×40) of the omental mass, parasitic worm-associated lesion with ragged margin, containing necrotic debris and amorphous eosinophilic material, H&E staining.

Fig. 6. Egg granuloma found in omental fat. Characteristic concentric lamination around a degenerating egg in seen, H&E staining (×100).

Fig. 7. Low power picture (×40) of ovary section, showing cavitary parasitic lesion in the middle of the ovarian parenchyme. OC represents ovarian capsule and white arrow indicates ovarian ovum and black arrows indicate parasitic ova, H&E staining.

Fig. 8. Adult P. westermani isolated from an omental mass, acetocarmine staining.

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2. Chung JJ, et al. J Korean Med Ass 1968;11:765–768.
3. Hsu CT, Ma YM, Wang TT. Paragonimiasis involving female genital organs. Report of two cases. Obstet Gynecol 1959;14:461–466.
4. Musgrave WE. Phil J Sci 1907;2:15–65.
5. Rim HJ, Chang YS, Lee JS, Joo KH, Suh WH, Tsuji M. Clinical Evaluation Of Praziquantel(Embay 8440; Biltricide(R)) In The Treatment Of Paragonimus Westermani. Korean J Parasitol 1981;19(1):27–37.
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