{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T05:52:06Z","timestamp":1785909126794,"version":"3.56.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"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>\n                      <jats:italic>Paragonimiasis<\/jats:italic>\n                      is a food-borne zoonotic parasitic disease caused by\n                      <jats:italic>Paragonimus<\/jats:italic>\n                      species, mainly acquired through ingestion of raw or undercooked freshwater crustaceans. Owing to its non-specific clinical manifestations, this disease is often misdiagnosed as pulmonary tuberculosis, bacterial pneumonia, or lung cancer.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      The patient was a 54-year-old male who initially presented with pyopneumothorax, along with a history of raw food consumption, chest wall subcutaneous nodules, peripheral eosinophilia, and left-sided pyopneumothorax. Video-assisted thoracoscopic surgery (VATS) was performed, during which live adult\n                      <jats:italic>Paragonimus<\/jats:italic>\n                      worms were directly visualized and extracted; post-operatively, the patient received praziquantel for antiparasitic treatment. He achieved complete recovery following VATS debridement combined with praziquantel therapy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This case underscores the diagnostic challenges posed by atypical pleural\n                      <jats:italic>Paragonimiasis<\/jats:italic>\n                      and highlights that VATS has important dual diagnostic and therapeutic value for highly suspected cases with inconclusive non-invasive workup in endemic regions, while serological testing and parasite ova detection remain first-line confirmatory methods for typical cases.\n                    <\/jats:p>\n                  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