Parasites, Hosts and Diseases

  • 제61권2호
  • /
  • Pages.202-209
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  • 2023
  • /
  • 2982-5164(pISSN)
  • /
  • 1738-0006(eISSN)
대한기생충학·열대의학회 (The Korea Society for Parasitology and Tropical Medicine)
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Lophomonas blattarum-like organism in bronchoalveolar lavage from a pneumonia patient: current diagnostic scheme and polymerase chain reaction can lead to false-positive results

  • Moses Lee (Department of Laboratory Medicine, Seoul National University Bundang Hospital) ;
  • Sang Mee Hwang (Department of Laboratory Medicine, Seoul National University Bundang Hospital) ;
  • Jong Sun Park (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Jae Hyeon Park (Department of Laboratory Medicine, Seoul National University Hospital) ;
  • Jeong Su Park (Department of Laboratory Medicine, Seoul National University Bundang Hospital)
  • 투고 : 2022.09.01
  • 심사 : 2023.02.16
  • 발행 : 2023.05.31
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초록

Lophomonas blattarum is an anaerobic protozoan living in the intestine of cockroaches and house dust mites, with ultramicroscopic characteristics such as the presence of a parabasal body, axial filament, and absence of mitochondria. More than 200 cases of Lophomonas infection of the respiratory tract have been reported worldwide. However, the current diagnosis of such infection depends only on light microscopic morphological findings from respiratory secretions. In this study, we attempted to provide more robust evidence of protozoal infection in an immunocompromised patient with atypical pneumonia, positive for Lophomonas-like protozoal cell forms. A direct search of bronchoalveolar lavage fluid via polymerase chain reaction (PCR), transmission electron microscopy (TEM), and metagenomic next-generation sequencing did not prove the presence of protozoal infection. PCR results were not validated with sufficient rigor, while de novo assembly and taxonomic classification results did not confirm the presence of an unidentified pathogen. The TEM results implied that such protozoal forms in light microscopy are actually non-detached ciliated epithelial cells. After ruling out infectious causes, the patient's final diagnosis was drug-induced pneumonitis. These findings underscore the lack of validation in the previously utilized diagnostic methods, and more evidence in the presence of L. blattarum is required to further prove its pathogenicity.

키워드

과제정보

The authors are grateful for the technical assistance provided by the technicians of the hematology unit in the Department of Laboratory Medicine, Seoul National University Bundang Hospital.

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