title: Bronchopulmonary Disease Caused by Flagellated Protozoa Infection in 15 Chinese Children.
abstract: Bronchopulmonary disease caused by flagellated protozoa infection (BPFP) is thought to be rare in children but may be an emerging or underestimated disease, especially in developing countries.
  
  
  
  In this study, we retrospectively reviewed records of 15 patients who were presented with a cough, wheezing or bronchopulmonary disease of unknown causes during admission, and patients who were finally diagnosed with BPFP from January 2014 to January 2015 were enrolled. Protozoa were observed in bronchoalveolar lavage fluid by light microscopy.
  
  
  
  A total of 15 pediatric cases (11 male and 4 female individuals, from 1 year 8 months to 12 years 1 month of age) with flagellated protozoa infection diagnosed by light microscopy were recruited. The course of the disease at the time of diagnosis was from 10 days to 11 months. Patients presented with a fever (N = 9), cough (N = 11), wheezing (N = 5) and chest pain (N = 5). Laboratory data showed elevated peripheral blood leucocytes (N = 6), eosinophilic granulocytes (N = 3), C-reactive protein (N = 5) and immunoglobulin E (N = 3). Bronchoscopy revealed a mucus plug (N = 3) and bronchiectasis (N = 1). Lung computed tomography results indicated ground-glass opacification (N = 2), atelectasis (N = 3), bronchiectasis (N = 1), bronchial wall thickening (N = 3) or nodular opacity (N = 6, including 1 case of pulmonary embolism). All children responded to metronidazole for a 2- to 5-week treatment period.
  
  
  
  Patients with BPFP often have a chronic or recurrent course and present with recurrent fever, cough, wheezing and chest pain. Chest imaging may reveal ground-glass opacification, atelectasis, bronchiectasis or nodular opacity (including pulmonary embolism). BPFP responds favorably to metronidazole treatment.
authors.affiliation: From the *Department of Respiratory Medicine, Beijing Children's Hospital, and †Microbiology Department, Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors.forename: Jinrong
authors.initials: J
authors.lastname: Liu
authors.forename: Shaogang
authors.initials: S
authors.lastname: Li
authors.forename: Huimin
authors.initials: H
authors.lastname: Li
authors.forename: Yimu
authors.initials: Y
authors.lastname: Fan
authors.forename: Haiming
authors.initials: H
authors.lastname: Yang
authors.forename: Hui
authors.initials: H
authors.lastname: Xu
authors.forename: Yuelin
authors.initials: Y
authors.lastname: Shen
authors.forename: Shunying
authors.initials: S
authors.lastname: Zhao
mesh_terms: D000981:Antiprotozoal Agents / Q000627:therapeutic use; D001992:Bronchoalveolar Lavage Fluid / Q000469:parasitology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008168:Lung / Q000000981:diagnostic imaging / Q000469:parasitology / Q000473:pathology; D008171:Lung Diseases / Q000175:diagnosis / Q000469:parasitology / Q000473:pathology; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D056900:Parabasalidea; D011528:Protozoan Infections / Q000175:diagnosis / Q000469:parasitology / Q000473:pathology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D000981:Antiprotozoal Agents; D008795:Metronidazole