Lophomoniasis broncopulmonar: a propósito de varios casos y revisión de la literatura

Abstract

Lophomoniasis is a parasitic infection caused by a commensal protozoan located in arthropods such as cockroaches and termites. It is transmitted to humans through inhalation of the cystic forms of the parasite that are contained in the feces produced by these insects, and is associated with relatively close contact. between the reservoir and the man.

It is an infection of recent epidemiological importance due to the considerable increase in the reporting of cases in recent decades in Latin American countries, especially those in the tropics and on the Asian continent. There are many gaps in the literature about its life cycle, interaction with humans, epidemiological factors, and risk factors for transmission and infection.

Its clinical importance lies in the bronchopulmonary disease it produces, with symptoms indistinguishable from other acute infectious lung pathologies, but which can additionally become chronic by activation of the host's immune response, simulating non-infectious chronic respiratory diseases. These non-specific characteristics explain the low clinical suspicion, erroneous approaches, the non-administration of specific management and the lack of response to treatments for the most common respiratory diseases.

The diagnosis is made by direct visualization of the protozoan in respiratory samples and the first-line treatment is a short course of metronidazole.

We present 3 cases identified in a high complexity institution in the city of Medellin (Colombia), which were characterized by the presence of non-specific respiratory symptoms such as cough, progressive dyspnea and variable evolution time. During the in-hospital evaluation, diagnostic aids were performed that were initially guided to common respiratory pathologies and that subsequently allowed the incidental discovery of the protozoan in all cases and with this, the appropriate treatment was initiated.

The recognition of this parasitic infection will lead to a better understanding of behavior and interaction with humans, to observe epidemiological characteristics, risk factors and in turn will allow us to know the local incidence and carry out possible measures to prevent the pathology.