Rare Diseases & Orphan Drug

Introduction: Lophomonas Blattarum is a round-oval shaped protozoan, 20-60 μM diameter with apical tuft of numerous fl agellate. It resides as an endocommensal in the hindgut of insects such as cockroaches. It’s increasingly being recognized as one of the cause bronchopulmonary infection.

 

Case Report: A 22-year-old female presented with complaints of cough with blood clots in expectorant, breathlessness on exertion, wheeze and low-grade fever, for past one year. Before arriving to our Outpatient Department (OPD), patient had consulted other medical centers. Th ere she was diagnosed with tuberculosis. In our OPD she was reviewed with previous reports, advised new investigations, continued on Antitubercular Therapy (ATT) and was planned for bronchoscopy. The Bronchoaleveolar Lavage (BAL) was sentfor laboratory testing. Wet mount of the sample revealed a motile multifl agellate protozoan resembling ciliated respiratory epithelium. Aft er further assessment, it was reported as Lophomonas blattarum. Th e patient was kept on ATT, while awaiting Mycobacterium Tuberculosis (MTb) test results. Ongoing ATT had no positive eff ect patient’s condition. Patient was admitted and started on Anti-protozoan treatment.

 

Discussion: It is diffi cult to diff erentiate Lophomonas blattarum symptoms from other respiratory infections displaying similar symptoms. Laboratory diagnosis relies on identifi cation of morphological features under light microscopy. Missed identifi cation could be due to delayed sample processing and its close resemblance to bronchial epithelium. With development of serological and molecular methods of identifi cation, diagnosis and treatment can improve.