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February 24, 1945


JAMA. 1945;127(8):461-462. doi:10.1001/jama.1945.02860080033012

When patients complain of chronic cough, pain in the chest and bloody sputum the physician today considers tuberculosis, lung tumor and bronchiectasis in the differential diagnosis, with lesser consideration to blastomycosis and other diseases. To these, in the case of men who have been in the tropics and particularly the Asiatic-Pacific theater, paragonimiasis, or endemic hemoptysis, caused by infection with the lung fluke Paragonimus westermani, must now be added.

Miller and Wilbur1 have recently reported 3 cases in Marines and have seen 4 others. Numerous additional cases will no doubt be reported as the disease increases and as it is recognized. Paragonimiasis is contracted by eating raw or inadequately cooked crabs or crayfish. The encysted metacercariae (larval worms) so ingested burrow through the jejunum into the peritoneal cavity; then they migrate to the lungs and sometimes to other parts of the body. Small nodular granulomatous lesions are formed about