A Case of Pulmonary Trichomoniasis in a Young Healthy Male / 결핵및호흡기질환

Bronchopulmonary infections caused by trichomonads have been reported principally in patients with pre-existing pulmonary diseases, such as bronchial carcinoma, lung abscess, or bronchiectasis. Pulmonary trichomoniasis is most often caused by Trichomonas tenax, which is usually regarded as a harmless commensal organism of the human mouth. However, pulmonary infection may rarely be caused by other trichomonas species, including Trichomonas vaginalis from the genitourinary tract and Trichomonas hominis from the intestines. Because of the rarity of trichomonas pulmonary infection, and because of its close association with underlying lung and systemic disease, pulmonary trichomoniasis is considered an opportunistic infection. We recently treated a case of pulmonary trichomoniasis occurring in a young, healthy male without obvious underlying pulmonary or systemic illness. To our knowledge, there has been only one reported case of pulmonary trichomoniasis in Korea, and there have been only two reported cases of pulmonary trichomoniasis occurring in normal lung worldwide.

A Case of Pulmonary Trichomoniasis / 대한임상병리학회지

Man is host to three distinct trichomonad species such as Trichomonas vaginalis, T. hominis, and T. tenax. Although reports of trichomonads found outside their natural habitat are rare, sporadic case reports have appeared describing trichomonads in the respiratory tract. The route of infection is unknown, but possible mechanisms include invasion from mouth, oral sex, bronchopleural or pleuroenteral fistula. Pulmonary trichomoniasis is a kind of oppotunistic infection and is usually caused by aspirated T. tenax in male adult patientis with chronic purulent or necrotic pulmonary disease. A 63-year-old male patient with alcoholic liver cirrhosis and chronic bronchiectasis was admitted due to copious sputum, dyspnea, fever and severe weight loss. On the thoracentesis from his right pleural cavity, 1 L of foul-smelling, brownish-yellow exudate was withdrawn and showed a large number of neutrophil, bacteria and numerous flagellated, actively motile organisms with typical appearance of thrichomonads in wet preparation. This patient was expired due to sepsis and insufficiency of multiple organs inspite of chemotherapy with metronidazole, cefuroxime and gentamicin on day 35 of admission. So, we report the first case of pulmonary trichomoniasis diagnosed in wet preparation of pleural fluid in Korea.