{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T06:08:28Z","timestamp":1779170908903,"version":"3.51.4"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012542","name":"Sichuan Provincial Science and Technology Support Program","doi-asserted-by":"publisher","award":["2024YFFK0144"],"award-info":[{"award-number":["2024YFFK0144"]}],"id":[{"id":"10.13039\/100012542","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pulmonary parasitic infections are notorious \u201cgreat masqueraders\u201d in clinical practice, with presentations including hemoptysis and non-specific cavitary nodules that overlap extensively with common pulmonary diseases. Diagnostic challenges are exacerbated by unusual paratenic transmission routes and extensive serological cross-reactivity among trematodes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      A 38-year-old male deer and dog breeder with raw deer blood consumption history presented with 2 months of cough and intermittent hemoptysis. Outside hospital chest CT revealed a right lower lobe (RLL) cavitary nodule, with initial lung biopsy only showing chronic inflammation. Laboratory workup identified progressive peripheral eosinophilia (up to 22.4%), massive eosinophilic pleural effusion (66% of nucleated cells) with extreme low pleural fluid glucose (0.10 mmol\/L), and broad serological cross-reactivity (positive\n                      <jats:italic>Clonorchis sinensis<\/jats:italic>\n                      ,\n                      <jats:italic>Schistosoma japonicum<\/jats:italic>\n                      , and\n                      <jats:italic>Paragonimus westermani<\/jats:italic>\n                      IgG) with normal hepatobiliary ultrasound. Expert pathological consultation of the initial biopsy slides identified parasitic ova within multinucleated giant cells, confirming the diagnosis. The patient was treated with praziquantel, with complete symptom resolution and radiological regression at 2.5-month follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Massive eosinophilic pleural effusion combined with extreme low pleural fluid glucose is a pathognomonic clue for pulmonary parasitic infection. Histopathology remains the diagnostic gold standard, while cytomorphology is indispensable for resolving serological ambiguity, underscoring the pivotal role of laboratory medicine in atypical parasitic infection diagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1833563","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T05:39:14Z","timestamp":1779169154000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Definitive diagnosis of pulmonary parasitic infection via cytomorphology and histopathology in a patient with non-specific pulmonary nodules and hemoptysis after raw deer blood consumption"],"prefix":"10.3389","volume":"13","author":[{"given":"Chi","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu","place":["Sichuan, China"]},{"name":"Sichuan Clinical Research Center for Laboratory Medicine, Chengdu","place":["Sichuan, China"]},{"name":"Clinical Laboratory Medicine Research Center of West China Hospital, Chengdu","place":["Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianxia","family":"Tao","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu","place":["Sichuan, China"]},{"name":"Sichuan Clinical Research Center for Laboratory Medicine, Chengdu","place":["Sichuan, China"]},{"name":"Clinical Laboratory Medicine Research Center of West China Hospital, Chengdu","place":["Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shanying","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu","place":["Sichuan, China"]},{"name":"Sichuan Clinical Research Center for Laboratory Medicine, Chengdu","place":["Sichuan, China"]},{"name":"Clinical Laboratory Medicine Research Center of West China Hospital, Chengdu","place":["Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"He","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu","place":["Sichuan, China"]},{"name":"Sichuan Clinical Research Center for Laboratory Medicine, Chengdu","place":["Sichuan, China"]},{"name":"Clinical Laboratory Medicine Research Center of West China Hospital, Chengdu","place":["Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"686","DOI":"10.1016\/j.chest.2024.10.046","article-title":"Parasitic infections in pulmonary and ICU patients: presentation, diagnosis, and 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