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Objective:To investigate the clinical manifestations, diagnosis, and treatment methods of Lophomonas blattarum infection combined with paragonimiasis in children, and improve pediatricians' understanding of the disease. Methods:The clinical data of two children with Lophomonas blattarum infection combined with paragonimiasis who received treatment in the Department of Pediatrics of The First People's Hospital of Yunnan Province were retrospectively analyzed. Children's clinical manifestation and diagnosis and treatment were analyzed. Relative literature was reviewed. Results:Case 1 had the onset of gastrointestinal symptoms. Case 2 had the onset of headache and liver dysfunction. Routine blood tests showed elevated eosinophils two cases and sputum examination results revealed the presence of live eggs of Lophomonas blattarum and paragonimiasis in two cases. Fecal roundworm eggs were also detected in case 1. Follow-up results showed that both cases were cured after treatment with metronidazole injection and praziquantel tablets. Conclusion:Lophomonas blattarum infection is a relatively rare opportunistic infection. Paragonimiasis is a natural parasitic disease that affects both humans and animals. Mixed infection of the two pathogens is rare. We hope that the findings from this paper will broaden clinical physicians' thoughts and guide clinical practice.
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Resumen La infección por Lophomonas es una infección rara comúnmente asociada con pacientes inmunosuprimidos. El diagnóstico de las infecciones es realizado mediante la observación directa bajo el microscopio de luz de muestras de secreción bronquial obtenido por aspiración, cepillado broncoalveolar o biopsia pulmonar, al buscar otros agentes. En los pacientes con COVID-19, el uso de fármacos inmunosupresores y la presencia de comorbilidades podría contribuir al desarrollo de este tipo de infecciones. Presentamos el caso de una paciente con neumonía por COVID-19 que desarrolló síndrome de insuficiencia respiratoria aguda grave y se documentó Lophomonas en frotis de secreción bronquial.
Abstract Lophomonas infection is a rare infection commonly associated with immunosuppressed patients. The diagnosis of infections is made by direct observation under the light microscope of samples of bronchial secretion obtained by aspiration, bronchoalveolar brushing or lung biopsy, when looking for other agents. In COVID-19 patients, the use of immunosuppressive drugs and the presence of comorbidities could contribute to the development of this type of infection. We present the case of a patient with COVID-19 pneumonia who developed severe acute respiratory distress syndrome and Lophomonas was documented in bronchial secretion smears.
Resumo A infecção por Lophomonas é uma infecção rara comumente associada a pacientes imunossuprimidos. O diagnóstico das infecções é feito pela observação direta ao microscópio de luz de amostras de secreção brônquica obtidas por aspiração, escovação brônquica alveolar ou biópsia pulmonar, na busca de outros agentes. Em pacientes com COVID-19, o uso de drogas imunossupressoras e a presença de comorbidades podem contribuir para o desenvolvimento desse tipo de infecção. Apresentamos o caso de um paciente com pneumonia por COVID-19 que desenvolveu síndrome do desconforto respiratório agudo grave e Lophomonas foi documentado em esfregaços de secreção brônquica.
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Resumen: La lophomoniasis pulmonar es una infección por un protozoario sumamente rara, está asociada con enfermedades crónicas que comprometen la respuesta inmune; sus manifestaciones son erráticas en muchos de los casos, por lo que se retrasa el diagnóstico y el tratamiento oportuno, lo que lleva a complicaciones graves. Presentamos a paciente obstétrica complicada con síndrome de preeclampsia-eclampsia que fue expuesta a corticoide como madurador pulmonar fetal, la cual desarrolló neumonía con SIRA grave, y se documentó en frotis de secreción bronquial Lophomonas spp., recibió tratamiento específico con recuperación clínica.
Abstract: Pulmonary lophomoniasis is an extremely rare protozoan infection, it is associated with chronic diseases that compromise the immune response, its manifestations are in many cases erratic, which delays the diagnosis and timely treatment, leading to complications serious. We present obstetric patient complicated with preeclampsia eclampsia syndrome that was exposed to corticoids as fetal pulmonary maturing, developing pneumonia with severe ARDS, documented in smear of bronchial secretion Lophomonas ssp., received specific treatment with clinical recovery.
Resumo: A lophomoniase pulmonar é uma infecção protozoária extremamente rara, está associada a doenças crônicas que comprometem a resposta imune, suas manifestações são em muitos casos erráticas, por isso o diagnóstico e o tratamento oportuno são tardios levando a complicações sérias. Apresentamos uma paciente obstétrica complicada com síndrome de eclâmpsia pré-eclâmpsia que foi exposta ao corticóide como um madurador pulmonar fetal, desenvolvendo pneumonia com SIRA grave, documentada com frotis de secreção brônquica Lophomonas ssp, recebeu tratamento específico com recuperação clínica.
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Human infections with Lophomonas blattarum are rare. However, the majority of the infections occurred in China, 94.4% (136 cases) of all cases in the world. This infection is difficult to differentiate from other pulmonary infections with similar symptoms. Here we reported a case of L. blattarum infection confirmed by bronchoalveolar lavage fluid smear on the microscopic observations. The patient was a 21-year-old female college student. The previous case which occurred in Chongqing was 20 years ago. We briefly reviewed on this infection reported in the world during the recent 20 years. The epidemiological characteristics, possible diagnostic basis, and treatment of this disease is discussed in order to provide a better understanding of recognition, diagnosis, and treatment of L. blattarum infection.
Asunto(s)
Femenino , Humanos , Adulto Joven , Enfermedades Pulmonares Parasitarias/diagnóstico , Parabasalidea/aislamiento & purificación , Infecciones por Protozoos/parasitologíaRESUMEN
Objective To improve the recognition and diagnosis of pulmonary Lophomonas blattarum infection. Methods Two cases of bronchopulmonary Lophomonas blattanan diagnosed in this hospital were reported. The clinical features of 13 cases in the literature during the period of 1993 to 2006,1 case with sinus infection and 12 cases with bronchopulmonary infection, were also analyzed. Results For the 2 cases diagnosed in this hospital, severe asthma and bronchiectasis withprolonged infection were the underlying diseases, respectively. The diagnosis of these 2 cases and the 13 cases reported in the literature were all confirmed by the presence of parasites in airway samples. The most common symptoms included fever (64.3% ), cough and expectoration (71.4%). Fifty percent of the patients showed increased eosinophils in peripheral blood. Chest radiograph and CT scan showed changes similar to pneumonia(83.3%). Chronic cases were manifested with asthma attack, branchiectasis or lung abscess. Smear preparations of sputum or specimen by bronchoscopy were direct methods for diagnosis. Conclusion Pulmonary Lophonomas blattarum infection is an emerging infectious disease caused by protozoon of hypermastigote parasitized in the bronchus or the lung. Epidemiological characteristics including host, route of transmission and susceptible population of Lophomonas blattarum infection are not fully understood. The optimal treatment also needs further investigation.
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The clinical features of Lophomonas blattarum infection in 26 patients with bacterial pneumonia were analyzed.Common manifestation included fever,cough and breathlessness.Computed tomography(CT)showed interstitial change and alveolar exudation.The parasites were found in sputum smear and from the bronchoalveolar lavage fluid(BALF).Metronidazole was effectively used to cure the pulmonary infection of L.blattarum.