A patient with paragonimiasis may shed eggs into the sputum. Identification of eggs in the sputum can aid in the diagnosis.
A major limitation of sputum analysis for eggs is the low sensitivity of a single examination. Multiple and/or pooled samples may need to be examined. The sensitivity can be improved by carefully selecting patients for sputum analysis.
A good candidate for sputum analysis may have one or more of the following:
(1) diffuse pulmonary disease with cavities seen on chest X-ray
(2) hemoptysis
(3) "rusty" sputum with small particles
Rarely an adult worm may be expectorated which can simplify the diagnosis.
Molecular techniques should improve the sensitivity of sputum analysis in the future.
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