Pulmonary superinfection by trichomonads in the course of acute respiratory distress syndrome.
The finding of trichomonads in bronchoalveolar lavage fluid (BALF) samples from an acute respiratory distress syndrome (ARDS) patient, never previously reported, incited us to search for these parasites retrospectively in the BALF of patients with ARDS or related pathologies. Eighty-four consecutive BALF samples have been reviewed. Results were compared with data from clinical files of patients included in this study. Detection and identification of trichomonads were based on cytologic characteristics. Subsequently, immunocytochemistry and in situ hybridization were performed in the last case of the series. Our results were as follows: (1) Trichomonads were detected in 25/84 BALFs (20/77 patients). Among the patients testing positive, 17 suffered from ARDS, about 30% of the ARDS patients included in the study. (2) Trichomonads were detected more frequently at a late ARDS stage. (3) No correlation was found between trichomonad detection and other data. (4) Within the group of trichomonad-infected ARDS patients, density of infection correlated with higher mortality. The late detection of these microorganisms in the course of ARDS suggested that trichomonad development is a secondary event. As BALFs obtained early in the course of ARDS were also included in the study, trichomonad incidence could be underestimated. The significance of trichomonad lung colonization in ARDS and its potential pathogenic role are unclear. Nevertheless, the question of an active role of trichomonads in the extension of alveolar lesions or in the limitation of recovery is clearly raised.
Duboucher
Christophe
C
Department of Pathology, Poissy/Saint-Germain Hospital, 20 Rue Armagis, 78100, Saint-Germain-en-Laye, France. christophe.duboucher@online.fr.
Barbier
Christophe
C
Department of Intensive Care, Poissy/Saint-Germain Hospital, Saint-Germain-en-Laye, France.
Beltramini
Alexandra
A
Department of Intensive Care, Poissy/Saint-Germain Hospital, Saint-Germain-en-Laye, France.
Rona
Marianne
M
Department of Pathology, Poissy/Saint-Germain Hospital, 20 Rue Armagis, 78100, Saint-Germain-en-Laye, France.
Ricome
Jean-Louis
JL
Department of Intensive Care, Poissy/Saint-Germain Hospital, Saint-Germain-en-Laye, France.
Morel
Gérard
G
The Unité Mixte CNRS-University Claude Bernard 5123, Villeurbanne, France.
Capron
Monique
M
The Inserm U547, Lille Pasteur Institute & Lille 2 University Hospital Centre (EA3609), Lille, France.
Pierce
Raymond J
RJ
The Inserm U547, Lille Pasteur Institute & Lille 2 University Hospital Centre (EA3609), Lille, France.
Dei-Cas
Eduardo
E
Department of Ecology of Parasitism, Lille Pasteur Institute & Lille 2 University Hospital Centre (EA3609), Lille, France.
Viscogliosi
Eric
E
The Inserm U547, Lille Pasteur Institute & Lille 2 University Hospital Centre (EA3609), Lille, France.
D000818:Animals; D001992:Bronchoalveolar Lavage Fluid / Q000469:parasitology; D003581:Cytodiagnosis; D018450:Disease Progression; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D012128:Respiratory Distress Syndrome / Q000469:parasitology*; D012141:Respiratory Tract Infections / Q000469:parasitology*; D012189:Retrospective Studies; D015163:Superinfection / Q000469:parasitology*; D014244:Trichomonas / Q000302:isolation & purification*; D014245:Trichomonas Infections / Q000469:parasitology*
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