The co-infection of pulmonary hydatid cyst, lophomoniasis and tuberculosis in a patient with resistant respiratory symptoms; a case report study

Abstract

Background Lophomonas blattarum is a rare protozoan that causes opportunistic infections, and the co-infection of lophomonas with tuberculosis and human hydatidosis is a serious public problem in the co-endemic areas of developing countries. Case report We presented a 58-year-old female with fever, losing weight, and cough with whitish-yellow sputum that started one month ago. Increasing inflammatory markers and hypereosinophilia in laboratory tests, and a cavity with thick, regular walls and undulating air-fluid levels measuring 43 × 30, evident in the upper segment of the right lower lobe (RLL), along with consolidation and the ground glass opacity of the upper segment and posterior basal of the RLL is apparent in CT scan were reported. Then, a bronchoscopy was requested, and the BAL specimen reported a negative fungal and bacterial infection in the samples. Several live and oval flagellated lophomonas protozoa, hydatid cyst protoscoleces (the larval forms of the parasites), and M. tuberculosis were observed in microscopic evaluation. The patient was treated with metronidazole, oral albendazole, and a combination of TB regimen. Conclusion Physicians should always consider the possibility of co-infections of lophomonas with tuberculosis and human hydatidosis and investigate patients with risk factors such as immunodeficiency conditions or treated with immunosuppressive medications.

Diagnosis of pulmonary lophomoniasis in an elderly anthracosis patient with resistant respiratory symptoms: A literature review and a case report study

“…Additionally, studies have documented cases of co‐infection or superinfection of lophomoniasis in individuals with underlying health issues. 7 In our study, the patient had diabetes, which could affect the immune system and lead to immunosuppression. This may have contributed to the patient's increased susceptibility to infections.…”

“…Infections attributed to L. blattarum typically manifest with atypical and nonspecific clinical symptoms, predominantly impacting the respiratory system and likely being transmitted through airborne routes. 7 , 8 , 9 These infections exhibit resemblances in terms of clinical manifestations and radiological characteristics. The absence of distinctive symptoms can create complexities in diagnosing and treating these infections, making it difficult to distinguish them from other medical conditions.…”

“…Clinical manifestations are typically nonspecific and include symptoms like cough, production of sputum, fever, chest discomfort, and respiratory distress. 6 , 7 …”