Hallazgo de Lophomonas sp. en secreciones del tracto respiratorio de niños hospitalizados con enfermedad pulmonar grave

Abstract

RESUMENLophomonas sp. es un parásito habitual del tracto intestinal de las cucarachas y que no es reconocido como patógeno humano. Sin embargo, en la literatura mundial existen escasos reportes de Lophomonas sp. en secreciones del tracto respiratorio en pacientes con enfermedad pulmonar grave, principalmente en adultos. Presentamos evidencias de Lophomonas sp. en el tracto respiratorio inferior de niños atendidos en el centro de referencia nacional de enfermedades pediátricas de Lima, Perú, en el periodo 2009-2010. Se encontró seis casos, 4/23 provenientes de muestras de lavado broncoalveolar y 2/794 muestras de aspirado traqueal de niños. Cinco de ellos tuvieron neumonía y uno atelectasia, cuatro estuvieron en la unidad de cuidados intensivos. Es necesario conocer más sobre la presencia de este organismo en infecciones respiratorias así como su rol patogénico real. Palabras clave: Infecciones por protozoarios; Enfermedades pulmonares parasitarias; Lavado broncoalveolar (fuente:DeCS BIREME). Lophomonas sp. IN RESPIRATORY TRACT SECRETIONS IN HOSPITALIZED CHILDREN WITH SEVERE LUNG DISEASE ABSTRACTLophomonas sp. is a habitual parasite of the intestinal tract of the cockroaches and that is not recognized as pathogenic human being. Nevertheless, in the world literature are few reports of Lophomonas sp. in respiratory tract secretions in patients with severe pulmonary disease, mostly in adults. We present evidences of Lophomonas sp. in the respiratory low tract of children attended in the national reference center of paediatric diseases of Lima, Peru, in the period 2009-2010. We found six cases, 4/23 from broncoalveolar lavage and 2/794 from tracheal aspirate samples of children. Five of them had pneumonia and one atelectasis, four were hospitalized in the intensive care unit. Increase knowledge about the presence of this organism in respiratory infections is needed, as its real pathogenic role. Recibido: 03-11-10 Aprobado: 01-12-10 Key words: Protozoan infections; Lung diseases, parasitic; Bronchoalveolar lavage (source: MeSH NLM). INTRODUCCIÓNLas infecciones pulmonares causadas por protozoarios adquieren cada vez mayor interés debido a que se presentan en pacientes inmunocomprometidos entre ellos los transplantados, entre quienes usan corticoides, con SIDA, tener neoplasias, entre otros (1,2) . Aunque se describen generalmente como reportes de caso, su presentación es cada vez más frecuente; entre los protozoarios implicados se encuentran patógenos que suelen atacar otros órganos y que esporádicamente afectan las vías respiratorias como:

Bronchopulmonary Infection of Lophomonas blattarum: A Case and Literature Review

“…So far, except for the 136 cases being concentrated in China, L. blattarum infection was also reported in humans in Peru in 2010 [ 4 ] and Spain in 2007 and 2010 [ 5 , 6 ]. There was 1 case of L. blattarum isolated from a houbara bustard that was a clinically normal bird in the United Arab Emirates in 1999 [ 7 ].…”

“…This protozoan parasite was identified by bronchoscopic brush smears, bronchoscopic biopsy smears, or bronchoalveolar lavage (BAL), and the patient was treated with metronidazole or tinidazole, with good prognosis. So far, L. blattarum human infections occur mainly in China, in addition to 6 cases from Peru in the National Reference Center of Pediatric Diseases of Lima from 2009 to 2010 [ 4 ], 2 cases from Spain [ 5 , 6 ], and 1 case of L. blattarum isolated from a clinically normal houbara bustard in the United Arab Emirates in 1999 [ 7 ].…”

Lophomonas blattarum Infection or Just the Movement of Ciliated Epithelial Cells?

“…Getting rid of duplicate cases, a total of 43 literatures were enrolled, of which 35 literatures were written in Chinese, seven in English, and one in Spanish. [ 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 ] One hundred and fifty-four cases were suffered from L. blattarum infection, including 149 cases of bronchopulmonary infection, three of sinus infection, one of urinary infection, and one of intrauterine infection. A majority of the bronchopulmonary infection cases were reported in China (141/149, 94.6%), in addition to six cases in Peru and two cases in Spain.…”

Lophomonas sp. in the upper and lower respiratory tract of patients from a hospital in Lambayeque, Peru: clinical case studies

“…Even though there are a series of cases published, there is not an active search yet, mainly because the personnel of the health system is not well-trained when identifying it and do not know its pathogenic function. Six cases have been reported in Peru [ 5 ] and after that, some isolated cases have been reported in populations with pulmonary affections [ 6 ].…”