Bronchopulmonary infection by Lophomonas blattarum- An emerging disease or a speculative myth?

Vandana Sardana; Saumya Srivastava; Sameer R. Verma

Volume : IX, Issue : VIII, August - 2020

Bronchopulmonary infection by Lophomonas blattarum- An emerging disease or a speculative myth?

Vandana Sardana, Saumya Srivastava, Sameer R. Verma

Abstract :

Introduction:Lophomonas blattarum is a multi flagellated protozoan, which is the endocommensal of the intestinal tracts of termites and cockroaches. Human infections with Lophomonas blattarum are rare but the association of Lophomonas and respiratory pathology, especially in immunocompromised individuals has recently gained concern. Aims & Objectives: i)To determine the frequency of ochopulmonary lophomoniasis in clinically diagnosed cases of respiratory tract infections. ii) To identify the risk factors associated with it. Methods: A retrospective data of three years was collected to study the number of onchoalveolar lavage fluids showing the presence of Lophomonas blattarum, submitted to the Department of Microbiology. Lophomonas blattarum was identified in onchoalveolar lavage fluid by direct microscopic examination of wet mount and / or Giemsa stained smear.Results: A total number of 1053onchoalveolar lavage fluids were received fromclinically diagnosed / suspected cases of respiratory tract infections. the frequency of occurence of Lophomonas blattarum in BAL fluids was found to be 1.14% (12/1053). Amongst the positive cases, predominant age group affected was ≥ 61 years, followed by 31–40 years, and females outnumbered males with tje ratio of 4.5:1.Bronchoulmonary Lophomonas infection was most commonly associated with diabetes (41.7 %), followed by prolonged corticosteroid therapy (33.3 %), chronic smoking (16.7 %) and cytotoxic chemotherapy (8.3 %).Conclusions: The observation of Lophomonas blattarum, in BAL fluids, under light microscopy, in patients who donot respond to antibiotics, but show satisfactory improvement with antiprotozoal therapy, can be labeled as onchopulmonary lophomoniasis. The development of molecular methods to resolve the issue regarding the confusion with other structures such as ciliated onchial cells and other endocommensals of gut of the termites,would be promising.