Guo-zhong Yao1, Li-qiang Zeng, Bo Zhang, Zheng-shan Chang. 1. Department of Respiratory Medicine, Shanghai Hospital of Chinese People's Armed Police Forces, Shanghai 201103, China. yaoguozh@yahoo.com.cn
Abstract
OBJECTIVE: To improve the recognition and diagnosis of pulmonary Lophomonas blattarum infection. METHODS: Two cases of bronchopulmonary Lophomonas blattarum 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 with prolonged 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, bronchiectasis or lung abscess. Smear preparations of sputum or specimen by bronchoscopy were direct methods for diagnosis. CONCLUSION: Pulmonary Lophomonas 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.
OBJECTIVE: To improve the recognition and diagnosis of pulmonary Lophomonas blattarum infection. METHODS: Two cases of bronchopulmonary Lophomonas blattarum 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 with prolonged 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, bronchiectasis or lung abscess. Smear preparations of sputum or specimen by bronchoscopy were direct methods for diagnosis. CONCLUSION:Pulmonary Lophomonas 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.