Differential diagnosis of lophomaniasis in patients with COVID-19 in northern Mexico: a case report
Diagnóstico diferencial de lofomaniasis en pacientes con COVID-19 en el norte de México: reporte de un caso
José de Jesús Alba-Romero, Benjamín Nogueda-Torres, Rosa María Sánchez-Manzano, Damari Lizeth Alba-Romero, Aurora Martínez-Romero
Abstract
Pulmonary lophomoniasis is a rare infection produced by a multiflagellated and anaerobic pyriform or oval protozoan belonging to the family of Lophomonadidae. The study aimed learn the differential diagnosis of lophomoniasis in patients with COVID-19 in northern Mexico. Clinical case of a 37-years-old male patient diagnosed with pneumonia, respiratory syndrome, hemoptysis, and fever, which suggested pulmonary tuberculosis. Bronchial lavage was performed, and laboratory tests were requested, an RT-PCR test to search for SARS-CoV-2, which was positive. The results for TB and KOH for fungi were negative. In addition to the protocol, a fresh examination was performed by placing a drop from the sample on a glass slide and observing it with a 10X objective, then 40X searching for clinically structural elements. As a result, multiflagellated cellular elements in the continuous movement were observed that morphologically correspond to the genus Lophomonas spp concluding the bacteriological protocol of bronchial secretions should consider fresh examination to search for trophozoites of Lophomonas spp. Medical and laboratory personnel are unaware of the protozoa Lophomonas spp, since the fresh examination in the analysis protocol is not considered. This paper reports the first case of Lophomonas infection in a patient caused by chronic lung disease.
Keywords
Resumen
La lofomoniasis pulmonar es una infección rara producida por un protozoo piriforme u ovalado multiflagelado y anaeróbico perteneciente a la familia de los Lophomonadidae. El estudio tuvo como objetivo conocer el diagnóstico diferencial de lofomoniasis en pacientes con COVID-19 en el norte de México. Caso clínico de un paciente masculino de 37 años con diagnóstico de neumonía, síndrome respiratorio, hemoptisis y fiebre, que sugería tuberculosis pulmonar. Se realizó lavado bronquial y se solicitaron pruebas de laboratorio, prueba RT-PCR para búsqueda de SARS-CoV-2, la cual resultó positiva. Los resultados de TB y KOH para hongos fueron negativos. Además del protocolo, se realizó un nuevo examen colocando una gota de la muestra en un portaobjetos de vidrio y observándola con un objetivo de 10X, luego 40X en busca de elementos clínicamente estructurales. Como resultado se observaron elementos celulares multiflagelados en movimiento continuo que morfológicamente corresponden al género Lophomonas spp, por lo que el protocolo bacteriológico de secreciones bronquiales debe considerar examen en fresco para búsqueda de trofozoítos de Lophomonas spp. El personal médico y de laboratorio desconoce la presencia del protozoo Lophomonas spp, ya que en el protocolo de análisis no se considera el examen en fresco. Este artículo reporta el primer caso de infección por Lophomonas en un paciente causado por una enfermedad pulmonar crónica.
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References
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Submitted date:
08/09/2023
Reviewed date:
10/10/2023
Accepted date:
10/31/2023
Publication date:
11/07/2023
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