Cysteine proteases: involved in metacercarial excystment, tissue invasion
Heavy infections
Dry cough/chronic cough, blood-stained or rust-colored sputum (fishy odor)
Erratic Paragonimiasis
Can go to heart and brain
Adult
Reddish brown, coffee bean-shaped, rounded anteriorly and slightly tapered posteriorly, found in pairs or threes in fibrotic capsules of the lung, adult firmly attached to the lung tissue, presence of spines on tegument (covering), intestinal ceca: wavy
Ova
Golden brown, operculated, big and large, ridge: opercular shoulder, presence of abopercular thickening (opposite operculum)