Objective:

To report a rare case of paragonimiasis presenting as a mediastinal mass in a pediatric patient and discuss the diagnostic challenges, highlighting its significance in the context of limited pediatric data.

Key Findings:

• The case highlights a rare presentation of paragonimiasis as a mediastinal mass, emphasizing the implications of initial misdiagnosis.
• Initial misdiagnosis as pneumonia complicated by mediastinitis occurred due to nonspecific symptoms, underscoring the need for careful evaluation.
• Histopathological examination confirmed the presence of parasitic cysts, reinforcing the diagnosis.

Interpretation:

Paragonimiasis can present atypically, complicating diagnosis; awareness of such presentations is crucial for timely treatment, particularly in pediatric cases.

Limitations:

• Limited pediatric data on paragonimiasis in China may affect generalizability, particularly regarding symptomatology and management.
• Follow-up imaging was declined, limiting assessment of treatment efficacy and long-term outcomes.

Conclusion:

This case underscores the importance of considering paragonimiasis in differential diagnoses for mediastinal masses in children, especially with relevant dietary history, to improve diagnostic accuracy.

Sources:

• Chinese Center for Disease Control