[A case of Paragonimus westermani complicated empyema by Streptococcus pneumoniae].

A 75-year-old man, who had eaten wild boar and deer repeatedly until November 2006, visited our hospital because of a right pleural effusion on chest X-ray films after he bruised a hip in January 2007. A right thoracocentesis revealed exudative pleural effusion with many neutrophils. Ten days after his first visit, a pleural biopsy specimen suggested the existence of parasite eggs. Twenty-six days after his first visit, he was admitted to our hospital because of leukocytosis, increased systemic inflammatory markers and a right pleural effusion. We found a great number of neutrophils, eggs of the Paragonimus species and gram-positive cocci in the pleural effusion. Streptococcus pneumoniae was also identified in his pleural effusion. In addition, a diagnosis of Paragonimiasis westermani was made serological study. After the continuous drainage of the pleural effusion, the patient was treated with praziquantel and antibiotics, and he gradually improved.