H. diminuta has a ubiquitous distribution worldwide, however, it is rarely found in humans(8). The definitive host as well as natural reservoirs of H. diminuta are rodents, i.e., rats and mice(9). Children and adults from poor socioeconomic group are more prone to infection because of unhygienic practices(10). The demonstration of H. diminuta eggs in the stool is the essential diagnostic tool. Most of the time this condition may be asymptomatic; however, vague abdominal pain and extraintestinal manifestations such as pruritus, irritation, and eosinophilia may be present(11). Given that most cases of H. diminuta infection have been reported in children, it is most likely that children acquire the infection through the ingestion of insects, whereas infection in adults probably occurs via the incidental ingestion of food contami-nated with infected insects or the willing ingestion of edible insects, either as part of traditional practices or due to the increased demand for new food sources or exotic dishes. Further studies are needed to identify risk factors for human hymenolepiasis caused by H. diminuta(7).
Here, we have reported an uncommonly encountered parasite H. diminuta especially in a prime-age man. There are few cases of human infections have been reported from china. It was the first report of human pulmonary infection of H. diminuta, based on our knowledge. Majority of the cases are asymptomatic, and the prevalence of infection in the community may be underestimated. Our case begins illness by cough and asthma. This case atypically presented as respiratory symptom and, as far as we know, respiratory symptom has never been reported as a clinical feature of symptomatic H. diminuta infection. Therefore, more effort should be put into improving our knowledge of the epidemiology and transmission routes of this uncommon human infection(12).
What’s more, we make a definite diagnosis for this case by extracting the alveolar lavage fluid through NGS. Due to the atypically present:age, area, and other atypical factors. We do not associate the case with parasitization. But NGS technology helps us make a definite diagnosis rapidly, with no delay and avoid misdiagnoses. It suggests that new technology can often surprise you in a big way.