Discovery of encysted Paragonimus westermani eggs in the omentum of an asymptomatic elderly woman

We report a case of asymptomatic chronic infiltrate of the omentum by eggs of Paragonimus westermani in an elderly woman who had immigrated to Taiwan from mainland China 46 years ago. The patient had a habit of eating raw freshwater crabs from the lakes of eastern China during her period of residence in that country. She stopped eating raw crabs after coming to Taiwan 20 years ago. During surgery for a peptic ulcer complicated by severe bleeding in 1995, her omentum was found to contain many small nodules approximately 2 x 2 x 1.5 cm in size. Biopsy of the nodules revealed eggs of P. westermani embedded in necrotic debris surrounded by capsules. A sputum examination result was negative and a chest radiograph was normal. The majority of the nodules in the omentum were removed during the surgery and praziquantel was given. At the present time, the patient remains asymptomatic.