[A case of Paragonimiasis westermanii complicated with migrating subcutaneous induration and multiple involvements in the liver].

A 33-year-old female was admitted to a hospital with chief complaints of abdominal pain, fever, cough and migrating subcutaneous induration. She had consumed half-cooked crabs 3 months ago. On admission, a mass in the abdominal wall, pleural effusion, a nodular shadow in the right upper lung on the chest X-ray and multiple low density areas in the liver on CT. Peripheral blood examination disclosed marked eosinophilia (5,300/mm3). Although we failed to detect any parasite eggs in stool, sputum and bronchogenic secretion, the immuno-serological test for parasites revealed an infection of paragonimus. Oral administration of praziquantel resulted in the disappearance of nodular shadow in the right upper lung, multiple low density areas on CT as well as migrating subcutaneous indurations. Migration of Paragonimus westermanii larvae to liver is known to be uncommon. Thus, the present case indicates an alternate migration route of the Paragonimus westermanii in humans.