Medscape is available in 5 Language Editions – Choose your Edition here.


Paragonimiasis Treatment & Management

  • Author: Seth D Rosenbaum, MD; Chief Editor: Russell W Steele, MD  more...
Updated: Jun 17, 2016

Medical Care

See the list below:

  • Antiparasitic therapy is the mainstay of paragonimiasis treatment.
  • Therapy may also be required for seizures caused by an inflammatory reaction to dying worms in the setting of cerebral paragonimiasis.

Surgical Care

See the list below:

  • Extrapulmonary lesions should be surgically excised.
  • An intraventricular shunt may be needed to manage hydrocephalus.


In addition to consultation with an infectious diseases specialist, the following may be helpful, depending on the particular manifestations of disease.

  • Pulmonologist
  • Neurologist
  • Surgeon
  • Neurosurgeon


See the list below:

  • Activity should be based on patient tolerance.
Contributor Information and Disclosures

Seth D Rosenbaum, MD Attending Physician in Infectious Diseases, Medical Specialty Associates, PA

Seth D Rosenbaum, MD is a member of the following medical societies: American College of Physicians, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America

Disclosure: Nothing to disclose.


Annette C Reboli, MD Professor of Medicine, University of Medicine and Dentistry of New Jersey; Head, Division of Infectious Diseases, Department of Medicine, Cooper University Hospital and University Medical Center

Annette C Reboli, MD is a member of the following medical societies: Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Chief Editor

Russell W Steele, MD Clinical Professor, Tulane University School of Medicine; Staff Physician, Ochsner Clinic Foundation

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, Southern Medical Association

Disclosure: Nothing to disclose.


Leslie L Barton, MD Professor Emerita of Pediatrics, University of Arizona College of Medicine

Leslie L Barton, MD is a member of the following medical societies: American Academy of Pediatrics, Association of Pediatric Program Directors, Infectious Diseases Society of America, and Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Jennifer Patterson, DO Fellow, Department of Infectious Diseases, Cooper University Hospital, Robert Wood Johnson School of Medicine

Jennifer Patterson, DO is a member of the following medical societies: American Osteopathic Association

Disclosure: Nothing to disclose.

  1. Liu Q, Wei F, Liu W, Yang S, Zhang X. Paragonimiasis: an important food-borne zoonosis in China. Trends Parasitol. 2008 Jul. 24(7):318-23. [Medline].

  2. Boe DM, Schwarz MI. A 31-year-old man with chronic cough and hemoptysis. Chest. 2007 Aug. 132(2):721-6. [Medline].

  3. Vidamaly S, Choumlivong K, Keolouangkhot V, Vannavong N, Kanpittaya J, Strobel M. Paragonimiasis: a common cause of persistent pleural effusion in Lao PDR. Trans R Soc Trop Med Hyg. 2009 Jan 29. [Medline].

  4. Fischer PU, Weil GJ. North American paragonimiasis: epidemiology and diagnostic strategies. Expert Rev Anti Infect Ther. 2015 Jun. 13 (6):779-86. [Medline].

  5. Rosen MJ. Chronic cough due to tuberculosis and other infections: ACCP evidence-based clinical practice guidelines. Chest. 2006 Jan. 129(1 Suppl):197S-201S. [Medline].

  6. Robertson KB, Janssen WJ, Saint S, Weinberger SE. Clinical problem-solving. The missing piece. N Engl J Med. 2006 Nov 2. 355(18):1913-8. [Medline].

  7. Cho AR, Lee HR, Lee KS, Lee SE, Lee SY. A case of pulmonary paragonimiasis with involvement of the abdominal muscle in a 9-year-old girl. Korean J Parasitol. 2011 Dec. 49(4):409-12. [Medline]. [Full Text].

  8. Nakamura-Uchiyama F, Mukae H, Nawa Y. Paragonimiasis: a Japanese perspective. Clin Chest Med. 2002 Jun. 23(2):409-20. [Medline].

  9. Xia Y, Ju Y, Chen J, You C. Cerebral paragonimiasis: a retrospective analysis of 27 cases. J Neurosurg Pediatr. 2014 Nov 7. 1-6. [Medline].

  10. Diaz JH. Boil before eating: paragonimiasis after eating raw crayfish in the Mississippi River Basin. J La State Med Soc. 2011 Sep-Oct. 163(5):261-6. [Medline].

  11. Tsang KW, File TM Jr. Respiratory infections unique to Asia. Respirology. 2008 Nov. 13(7):937-49. [Medline].

  12. Xia Y, Chen J, Ju Y, You C. Characteristic CT and MR imaging findings of cerebral paragonimiasis. J Neuroradiol. 2016 Jun. 43 (3):200-6. [Medline].

  13. Doanh PN, Dung do T, Thach DT, Horii Y, Shinohara A, Nawa Y. Human paragonimiasis in Viet Nam: epidemiological survey and identification of the responsible species by DNA sequencing of eggs in patients' sputum. Parasitol Int. 2011 Dec. 60(4):534-7. [Medline].

  14. Kyung SY, Cho YK, Kim YJ, Park JW, Jeong SH, Lee JI, et al. A paragonimiasis patient with allergic reaction to praziquantel and resistance to triclabendazole: successful treatment after desensitization to praziquantel. Korean J Parasitol. 2011 Mar. 49(1):73-7. [Medline]. [Full Text].

  15. Anonymous. Drugs for parasitic infections. Med Lett Drugs Ther. 2004 Aug. 46(1189):1-12.

  16. Blair D, Xu ZB, Agatsuma T. Paragonimiasis and the genus Paragonimus. Adv Parasitol. 1999. 42:113-222. [Medline].

  17. Calvopina M, Guderian RH, Paredes W, Chico M, Cooper PJ. Treatment of human pulmonary paragonimiasis with triclabendazole: clinical tolerance and drug efficacy. Trans R Soc Trop Med Hyg. 1998 Sep-Oct. 92(5):566-9. [Medline].

  18. Christie JD, Garcia LS. Emerging parasitic infections. Clin Lab Med. 2004 Sep. 24(3):737-72. [Medline].

  19. Dainichi T, Nakahara T, Moroi Y, et al. A case of cutaneous paragonimiasis with pleural effusion. Int J Dermatol. 2003 Sep. 42(9):699-702. [Medline].

  20. Hawn TR, Jong EC. Update on Hepatobiliary and Pulmonary Flukes. Curr Infect Dis Rep. 1999 Dec. 1(5):427-433. [Medline].

  21. Kagawa FT. Pulmonary paragonimiasis. Semin Respir Infect. 1997 Jun. 12(2):149-58. [Medline].

  22. Maguire JH. Trematodes (Schistosomes and other Flukes). Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, PA: Churchill Livingstone; 2004. Vol 2: 3283-4.

This micrograph depicts an egg from the trematode parasite Paragonimus westermani. Eggs range in size from 68-118 µm x 39-67 µm. They are yellow-brown and ovoidal or elongated, with a thick shell. They are often asymmetrical, with one end slightly flattened. At the large end, the operculum (ie, lid or covering) is visible. Photo courtesy of The Centers for Disease Control and Prevention.
This is an illustration of the life cycle of Paragonimus westermani, one of the causal agents of paragonimiasis. Photo courtesy of The Centers for Disease Control and Prevention.
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.