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The Co-Infection of Pulmonary Hydatid Cyst, Lophomoniasis and Tuberculosis in a Patient With Resistant Respiratory Symptoms; a Case Report Study Publisher Pubmed



Jalayeri MHT1 ; Sharifi Far RA2 ; Lashkarbolouk N3, 4 ; Mazandarani M3, 4
Authors
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Authors Affiliations
  1. 1. Pulmonary and Critical Care Division, Sayyad Shirazi Medical and Educational Center, Golestan University of Medical Sciences, Gorgan, Iran
  2. 2. Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran
  3. 3. Golestan University of Medical Sciences, Gorgan, Iran
  4. 4. Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran

Source: BMC Infectious Diseases Published:2024


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. © 2023, The Author(s).