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Diagnosis of Pulmonary Lophomoniasis Infection in Patient With Systemic Lupus Erythematosus; a Case Report and Literature Review Publisher



Jalayeri MHT1 ; Aghaei M2 ; Mazandarani M1, 3 ; Lashkarbolouk N1, 3 ; Sharifpour A4, 5
Authors
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Authors Affiliations
  1. 1. Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran
  2. 2. Rheumatology Research Center, Golestan University of Medical Sciences, Gorgan, Iran
  3. 3. Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Iranian National Registry Center for Lophomoniasis (INRCL), Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
  5. 5. Pulmonoary and Critical Care Division, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran

Source: Respirology Case Reports Published:2024


Abstract

Over the past 30 years, there has been an increasing number of documented human infections associated with the protozoan Lophomonas, specifically Lophomonas blattarum, which is considered a relatively rare infection. These infections are primarily associated with states of immune suppression, including those resulting from corticosteroid therapy. We report a 61-year-old female patient with a 20-year medical history of Systemic lupus erythematosus (SLE) who was admitted due to persistent respiratory symptoms that were unresponsive to treatment. The patient was receiving immunosuppressive therapy for SLE. Upon hospitalization, computed tomography of the lungs revealed the presence of centrilobular nodules exhibiting tree-in-bud patterns, as well as bronchiectasis, predominantly in the middle and lower lobes. Subsequently, the patient underwent bronchoscopy, during which a BAL sample was obtained. Microscopic analysis of the sample indicated the presence of L. blattarum. Clinicians often focus on the primary symptoms of SLE, but they must also consider the risk of severe respiratory complications like lophomoniasis. This condition is critical to address in the management of SLE patients, who are immunosuppressed due to the disease's nature and its treatment. © 2024 The Author(s). Respirology Case Reports published by John Wiley & Sons Australia, Ltd on behalf of The Asian Pacific Society of Respirology.