A rare case of hemoptysis due to Paragonimus westermanii: The tip of an iceberg?

Paragonimiasis, a parasitic infection caused by Paragonimus westermanii, presents with a range of symptoms, including chronic cough, chest pain, and hemoptysis, often mimicking tuberculosis. This case report describes the first documented case of Paragonimus westermanii infection in Bihar, India, presenting with hemoptysis. The patient, a 40-year-old female with a history of consuming smoked and improperly cooked crabs, exhibited eosinophilia and chest radiographic abnormalities. Microscopic examination of the sputum revealed characteristic Paragonimus eggs. Praziquantel treatment led to rapid symptom resolution. This case underscores the importance of considering paragonimiasis as an important differential diagnosis in regions where it is not widely recognized.