The co-infection of lophomoniasis and tuberculosis in patients with respiratory symptoms; case series and literature review

Background

Lophomonas blattarum is an emerging important cause of bronchopulmonary infections in immunocompromised patients. Moreover, Tuberculosis (TB) continues to be a significant factor in the mortality of infectious diseases, particularly in developing nations, serving as a primary cause of pneumonia.

Cases presentation

Our study reported six cases of lophomoniasis with tuberculosis co-infection. The median age of all cases reported was 51.83 years old, and 50 % of patients were male. All the adult patients had respiratory signs, with common symptoms of fever and dyspnea. The presence of leukocytes and anemia in the patients was common. We treated them with metronidazole 500 mg twice a day for two weeks and a combination of TB regimens.

Conclusion

We recommended identifying lophomoniasis during differential diagnoses of patients with pulmonary tuberculosis. Moreover, Timely diagnosis and treatment of lophomonas is crucial, as it requires a different treatment approach from pneumonia or TB. Clinical laboratories should consider the active search for this protozoan in these patients’ bronchoalveolar and tracheal liquid samples.