To investigate the clinical characteristics and misdiagnosis of paragonimiasis with pleural effusion as the main clinical manifestation.

A case of paragonimiasis with pleural effusion as main clinical manifestation was misdiagnosed as tuberculous pleurisy. After 3 months of anti-tuberculosis treatment, it was diagnosed as "cerebral paragonimiasis" due to "sudden convulsion twice" ; and furtherly diagnosed as "mixed paragonimiasis" .

Cerebral paragonimiasis complicated with pleural effusion was easily misdiagnosed as tuberculous pleurisy. According to the clinical manifestation, eosinophil count (EOS), and combination with immunological examination and other methods, the diagnosis was confirmed. After 5 successive courses of praziquantel treatment, clinical cure were obtained.

The main measures to reduce misdiagnosis and mistreatment and prevent the occurrence of important organ paragonimiasis are inquiring about the history of the disease carefully, examining the physical examination carefully, and analyzing the results of auxiliary examination scientifically. The treatment of paragonimiasis should follow the principle of individuation, and patients with long history of paragonimiasis, especially the cerebral paragonimiasis, may need multi-courses of treatment.