Pulmonary paragonimiasis: Close mimic to pulmonary tuberculosis in endemic regions

We, hereby, report a case of pulmonary paragonimiasis in a patient from an endemic region who was misdiagnosed with pulmonary tuberculosis as the clinical features of both diseases are the same. The subtle clue such as eosinophilia, food habits, and travel history can help us diagnose parasitic infections. Pulmonary paragonimiasis with coughing up rusty brown sputum is the most common presentation of the disease. Praziquantel is mainstay of treatment.