title: Pulmonary Lophomonas blattarum infection in patients with kidney allograft transplantation.
abstract: The aim of the study was to analyse the clinical manifestation and management of pulmonary Lophomonas blattarum infection in four allograft transplantation recipients retrospectively. Four patients with pulmonary L. blattarum infection were diagnosed by using Fiberoptic bronchoscopy (FOB) and bronchoalveolar lavage (BAL) examination. Their clinical manifestation and management are summarized. Four cases of pulmonary L. blattarum were found during the period from the second month to the third month after transplantation. Concurring infection by other pathogens was found in three of them. Common initial symptoms included fever (>38 degrees C) without cough and breathlessness. Lower lobe shadowing could be found on chest X-ray. Body temperature decreased to the normal range in three patients and to 37.5 degrees C in the other one, after intravenous injection of metronidazole and tapering immunosuppressant. Radiological examination confirmed improved health condition of the patients afterwards. Two patients received repeated FOB and only dead L. blattarum was found. Pulmonary L. blattarum infection in allograft transplant recipients carry relatively obscure initial symptoms. Possible L. blattarum infection needs to be screened in post-transplantation pulmonary infection patients with similar symptoms, especially in those who respond poorly to anti-infection treatment. Microscopic examination of BAL fluid can help to identify pulmonary L. blattarum infection and metronidazole is an ideal treatment choice.
authors.affiliation: Life Science Department of Nanjing University, Nan Jing, Jiang Su Province, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Wang
authors.forename: Zheng
authors.initials: Z
authors.lastname: Tang
authors.forename: Shuming
authors.initials: S
authors.lastname: Ji
authors.forename: Zhen
authors.initials: Z
authors.lastname: Zhang
authors.forename: Jinsong
authors.initials: J
authors.lastname: Chen
authors.forename: Zhen
authors.initials: Z
authors.lastname: Cheng
authors.forename: Dongrui
authors.initials: D
authors.lastname: Cheng
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Liu
authors.forename: Leishi
authors.initials: L
authors.lastname: Li
mesh_terms: D000328:Adult; D000818:Animals; D056890:Eukaryota / Q000302:isolation & purification*; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008174:Lung Diseases, Parasitic / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D011379:Prognosis; D014184:Transplantation, Homologous
chemical_list: D008795:Metronidazole