ABSTRACT
Pleural trichomonosis is clinically rare, and very few cases of trichomonal empyema have been reported so far. A rare case of an 81-year-old woman with pyopeumothorax presenting with recurrent fever and macroscopic pyuria was present. Microscopic examination of the pleural effusion showed mobile flagellated protozoa which molecular methods identified as Tetratrichomonas. In addition, Streptococcus anginosus was discovered in pleural fluid cultures. Treatment with imipenem/cilastatin and metronidazole successfully eliminated the pathogens and led to relief of clinical symptoms. In the context of a review of the relevant literature, the clinical application of molecular methods in the diagnosis of pleural trichomonosis is underlined.
Subject(s)
Empyema, Pleural/parasitology , Pleural Effusion/parasitology , Pneumothorax/parasitology , Trichomonadida/isolation & purification , Trichomonas Infections/diagnosis , Aged, 80 and over , Antiprotozoal Agents/therapeutic use , Cilastatin/therapeutic use , Empyema, Pleural/diagnosis , Empyema, Pleural/microbiology , Female , Humans , Imipenem/therapeutic use , Metronidazole/therapeutic use , Pleural Effusion/microbiology , Pneumothorax/diagnosis , Pneumothorax/microbiology , Streptococcal Infections/diagnosis , Streptococcal Infections/drug therapy , Streptococcus anginosus/isolation & purification , Trichomonas Infections/drug therapyABSTRACT
Myiasis refers to a parasitic infestation of vertebrate mammals by dipterous larvae (maggots) of higher flies. Infections in humans typically occur in tropical and subtropical regions, regions with limited medical access, and areas with poor hygiene and living conditions. Infestations in humans have been described in subcutaneous, nasal, ocular, oropharyngeal, and orotracheal cases; however, reports of pulmonary myiasis in humans in the United States and other developed countries are extremely rare. We describe a patient with recently diagnosed primary pleural angiosarcoma who presented to our clinic for the management of a thoracostomy tube and was diagnosed with pleural myiasis.
Subject(s)
Hemangiosarcoma , Myiasis , Paclitaxel/administration & dosage , Pleural Neoplasms , Thoracic Surgery, Video-Assisted/methods , Thoracostomy/methods , Aged , Anti-Bacterial Agents/administration & dosage , Antineoplastic Agents, Phytogenic/administration & dosage , Disease Management , Empyema, Pleural/etiology , Empyema, Pleural/microbiology , Empyema, Pleural/parasitology , Empyema, Pleural/therapy , Hemangiosarcoma/complications , Hemangiosarcoma/pathology , Hemangiosarcoma/physiopathology , Hemangiosarcoma/therapy , Humans , Hydropneumothorax/etiology , Hydropneumothorax/surgery , Male , Myiasis/complications , Myiasis/diagnosis , Myiasis/physiopathology , Myiasis/therapy , Pleural Cavity/parasitology , Pleural Cavity/pathology , Pleural Neoplasms/complications , Pleural Neoplasms/pathology , Pleural Neoplasms/physiopathology , Pleural Neoplasms/therapyABSTRACT
Two unusual occurrences of pleural trichomonosis due to a new Tetratrichomonas species previously reported but not named were confirmed. In one patient, Trichomonas tenax and a Tetratrichomonas species were also detected in the oral cavity by molecular methods. We suggest that this new Tetratrichomonas species be named Tetratrichomonas empyemagena.
Subject(s)
Empyema, Pleural/diagnosis , Empyema, Pleural/parasitology , Protozoan Infections/diagnosis , Protozoan Infections/parasitology , Trichomonadida/classification , Trichomonadida/isolation & purification , Adult , Cluster Analysis , DNA, Intergenic/chemistry , DNA, Intergenic/genetics , DNA, Protozoan/chemistry , DNA, Protozoan/genetics , DNA, Ribosomal/chemistry , DNA, Ribosomal/genetics , Humans , Male , Middle Aged , Molecular Sequence Data , Mouth/parasitology , Phylogeny , RNA, Ribosomal, 5.8S/genetics , Sequence Analysis, DNA , Trichomonadida/geneticsSubject(s)
Amebiasis/diagnosis , Empyema, Pleural/diagnosis , Empyema, Pleural/parasitology , Liver Abscess, Amebic/diagnosis , Pleural Effusion/parasitology , Trophozoites , Amebiasis/complications , Empyema, Pleural/complications , Humans , Liver Abscess, Amebic/complications , Male , Middle Aged , Pleural Effusion/complicationsABSTRACT
Pleural empyema formation is one of the potential complications of lower respiratory tract infections and it is characterized by bacterial organisms seen on gram stain or the aspiration of pus on thoracentesis. Very rarely empyema can be caused by trichomonas species, of which Trichomonas Tenax appears to be the most common cause. In this article we report the case of a 51-year-old man who developed a pleural empyema caused by trichomonas, and review the available literature of this rare infection of unknown incidence and uncertain pathogenetic significance. Our patient was treated with metronidazole, however complete cure was not achieved and pulmonary decortication was necessary for the successful outcome. As far as we know, this is the first case of pleural empyema caused by trichomonas reported in Chile.
La formación de un empiema pleural es una de las potenciales complicaciones de las infecciones de la vía aérea inferior, y se caracteriza por la observación de bacterias en la tinción de Gram, o la aspiración de pus en la toracocentesis. Muy infrecuentemente el empiema puede ser causado por alguna de las especies de tricomonas, de las cuales Trichomonas Tenax parece ser la causa más común. En este artículo, reportamos el caso de un hombre de 51 años que desarrolló un empiema pleural causado por tricomonas, y revisamos la literatura disponible de esta rara infección, de incidencia desconocida, y significancia patogénica incierta. Nuestro paciente fue tratado con metronidazol, observándose sólo una respuesta parcial, necesitándose decorticación pulmonar para una recuperación completa. Hasta donde sabemos, este es el primer caso de empiema pleural causado por tricomonas reportado en Chile.
Subject(s)
Humans , Male , Middle Aged , Empyema, Pleural/etiology , Empyema, Pleural/therapy , Trichomonas Infections/complications , Trichomonas Infections/therapy , Antitrichomonal Agents/therapeutic use , Drainage , Empyema, Pleural/surgery , Empyema, Pleural/parasitology , Empyema, Pleural/drug therapy , Metronidazole/therapeutic use , Thoracostomy , Trichomonas Infections/surgery , Trichomonas Infections/drug therapySubject(s)
Echinococcosis/diagnostic imaging , Thoracic Cavity/parasitology , Adult , Diagnosis, Differential , Drainage/methods , Echinococcosis/parasitology , Echinococcosis/surgery , Empyema, Pleural/diagnostic imaging , Empyema, Pleural/parasitology , Empyema, Pleural/surgery , Female , Humans , Radiography, Thoracic/methods , Thoracic Cavity/surgery , Thoracic Diseases/diagnostic imaging , Thoracic Diseases/parasitology , Thoracic Diseases/surgery , Thoracotomy/methods , Tomography, X-Ray Computed/methodsABSTRACT
A new Tetratrichomonas species was identified by molecular and phylogenetic approaches in the pleural fluid from a patient with encysted empyema leading to dyspnea. This observation raised the questions of the real prevalence of pulmonary trichomonosis in humans, the zoonotic potential of trichomonads, and the existence of human-host-adapted strains.
Subject(s)
Empyema, Pleural/parasitology , Protozoan Infections/diagnosis , Protozoan Infections/parasitology , Trichomonadida/classification , Trichomonadida/isolation & purification , Adult , Animals , Cluster Analysis , DNA, Protozoan/chemistry , DNA, Protozoan/genetics , DNA, Ribosomal/chemistry , DNA, Ribosomal/genetics , DNA, Ribosomal Spacer/chemistry , DNA, Ribosomal Spacer/genetics , Female , Genes, rRNA , Humans , Molecular Sequence Data , Phylogeny , RNA, Protozoan/genetics , RNA, Ribosomal, 5.8S/genetics , Radiography, Thoracic , Sequence Analysis, DNA , Trichomonadida/geneticsSubject(s)
Empyema, Pleural/parasitology , Entamoeba histolytica/isolation & purification , Liver Abscess, Amebic/complications , Amebicides/therapeutic use , Animals , Biopsy, Needle , Empyema, Pleural/drug therapy , Humans , Liver Abscess, Amebic/physiopathology , Male , Metronidazole/therapeutic use , Middle Aged , Tomography, X-Ray ComputedABSTRACT
A 5-year-old boy with recurrent liver abscesses and pleural empyema, presumed to be amoebic, is described. Despite surgical drainage of the liver and thoracic wall combined with metronidazole and chloroquine, he died 7 weeks after admission.
Subject(s)
Amebiasis/diagnosis , Empyema, Pleural/diagnosis , Amebiasis/therapy , Child, Preschool , Empyema, Pleural/parasitology , Empyema, Pleural/therapy , Fatal Outcome , Humans , Liver Abscess, Amebic/diagnosis , Liver Abscess, Amebic/therapy , Male , RecurrenceABSTRACT
Empyema is one of the potential complications of lower respiratory tract infections. Very rarely, in predisposed individuals, empyema can be caused by Trichomonas species, of which Trichomonas tenax appears to be the most common cause. Here, we present a case of trichomonal empyema in a 56-year-old man and review the available literature of this rare occurrence.
Subject(s)
Empyema, Pleural/parasitology , Trichomonas Infections/complications , Humans , Male , Middle AgedSubject(s)
Empyema, Pleural/parasitology , Liver Abscess, Amebic/diagnosis , Adult , Animals , Diagnosis, Differential , Drainage/methods , Entamoeba histolytica/isolation & purification , Humans , Liver Abscess, Amebic/complications , Liver Abscess, Amebic/therapy , Male , Refugees , Tomography, X-Ray Computed/methodsABSTRACT
A patient of tuberculous pyopneumothroax with broncho-pleural fistula in whom a mature roundworm Ascaris lumbricoides migrated from the intestine to lodge itself in the pleural cavity is being reported.
Subject(s)
Ascariasis/complications , Ascaris lumbricoides , Empyema, Pleural/parasitology , Lung Diseases, Parasitic/etiology , Pneumothorax/parasitology , Animals , Bronchial Fistula/parasitology , Humans , Male , Middle AgedABSTRACT
Trichomonas sp. was found in a patient with empyema and chronic obstructive pulmonary disease. This is a uncommon finding. A wet mount of pleural fluid is recommended to be observed by light microscopy.
Subject(s)
Empyema, Pleural/diagnosis , Trichomonas Infections/diagnosis , Aged , Animals , Bronchial Fistula/diagnosis , Empyema, Pleural/microbiology , Empyema, Pleural/parasitology , Humans , Male , Pleural Diseases/diagnosis , Pulmonary Atelectasis/diagnosis , Trichomonas/isolation & purification , Trichomonas Infections/microbiology , Trichomonas Infections/parasitologyABSTRACT
Trichomonas sp. was found in a patient with empyema and chronic obstructive pulmonary disease. This is a uncommon finding. A wet mount of pleural fluid is recommended to be observed by light microscopy