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Chronic Respiratory Allergy Caused by Lophomonas blattarum: A Case Report
Oghlniaz Jorjani , Abdolrahman Bahlkeh , Faramarz Koohsar , Beniamin Talebi , Ali Bagheri ,
Volume 12, Issue 2 (3-2018)
Abstract
ABSTRACT
        Background and Objective: Lophomonas blattarum is a multi-flagellate protozoan that is commensal in hindgut of cockroaches and other insects. The protozoan can cause respiratory infection in humans. Most cases of the infections with this protozoan have been reported in China. Here, we present a case with chronic respiratory allergy caused by L. blattarum in Golestan province, Iran.
         Case Description: The case was a 37-year-old male with history of respiratory conditions and he was immunocompetent. An athlete. L. blattarum was detected in direct smear examination of sputum,
        Conclusion: Since we found respiratory infection in an immunocompetent individual who was also an athlete, it is necessary to study this parasite and its life cycle and transmission methods. It is also suggested to consider L. blattarum infection and treatment with metronidazole in cases of chronic allergies, especially those that do not respond to treatment.
        Keywords: Lophomonas blattarum, Respiratory Allergies, Iran.

Bronchopulmonary lophomoniasis in a prisoner: A case report
Sadeghali Azimi , Bahareh Bashardoust , Mohammad Hadi Tajik Jalayeri ,
Volume 19, Issue 2 (3-2025)
Abstract
Background: Bronchopulmonary lophomoniasis, an emerging yet frequently overlooked respiratory infection, is caused by the flagellated protozoan Lophomonas blattarum (L. blattarum). Although predominantly observed in immunocompromised individuals, its occurrence in immunocompetent hosts, particularly within high-risk settings like correctional facilities, is uncommon.
Case Presentation: This report details the case of a 47-year-old male prisoner from Golestan Province, Iran, who presented with a four-month history of chronic cough, dyspnea, and purulent sputum. The initial diagnostic workup, including blood and sputum cultures, yielded no evidence of bacterial or fungal infection. However, microscopic examination of bronchoalveolar lavage (BAL) fluid revealed L. blattarum trophozoites, leading to a definitive diagnosis of lophomoniasis. Of particular interest was the elevated serum immunoglobulin E (IgE) level (387 kU/L; normal range <160 kU/L), which may indicate an underlying allergic predisposition or a concurrent parasitic infection. The patient's symptoms resolved completely after a four-week regimen of metronidazole.
Conclusion: This case highlights the importance of considering lophomoniasis in the differential diagnosis of chronic respiratory symptoms, especially in settings with poor hygiene. For accurate diagnosis in similar patient populations, a heightened clinical suspicion combined with BAL microscopy are essential.

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