Answer to Case 67

Answer: Paragonimus spp.

As Dr. R points out, this specimen is on the smaller end of the spectrum, being just 5 mm in length (typical size 6-10 mm), but it otherwise has all of the characteristic features of a Paragonimus adult fluke. It is typically described grossly as a "coffee bean," and has 2 suckers (as do all human flukes) - 1 ventral and 1 anterior. I've attempted to show the anterior sucker in the close-up image, but it's a bit hard to make out. I've also given you a big hint with the history of hemoptysis. Paragonimus is the lung fluke, and creates cystic cavities in the lung parenchyma.

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