**4. Discussion**

To the cases reported in Peru, China and Spain (**Table 2**), where they found this protozoon in sputum samples, we must add 1 case recorded of a sinusitis in Iran [9], and this one that we are presenting from Mexico, since they have in common denominator deficiencies in the immune system, which makes them extremely sensitive to any infection no matter how mild. It also indicates a possible airborne transmission, with the influence of a humid environment through waste and environmental dust, and that by aspiration, the trophozoites or protozoan cysts can lodge in the bronchopulmonary epithelium, developing the infection with manifestations similar to any bacterial or fungal pulmonary pathology, which makes diagnosis even more difficult.

Our patient presented with respiratory symptoms that indicated possible miliary tuberculosis or some acute respiratory pathology, since in the expectorant product blood threads were observed in some of the emissions, so that without the saline solution wet study, the differential diagnosis would not have been possible to reach.

The immunological commitment of the patient was a crucial and decisive factor for the development of the infection, as self-medication and the lack of an accurate diagnosis were important factors to delay his full recovery.


**265**

**Figure 9.**

*Bronchopulmonary Lophomoniasis, Infection by Endocommensal Protozoa of Intradomiciliary…*

**Autor(s) y años Caso(s) registrados País** Zerpa et al. (2010) 6 Perú Zhang, F. et al. [45] 6 China Zhang, R. S. et al. [46] 1 China Zhang et al. [47] 1 China Zhou et al. [48] 1 China **Fariba Berenji et al., 2015 1 Irán Villagrán et al. 2016 1 México**

This particular case has been the first diagnosed in the city of Querétaro and reported in the Mexican Republic and illustrates casual infection of *L. blattarum*, a rare opportunistic pathogen, probably acquired by air, developing the patient's lung infection, due to his immunocompromised state. It is essential that doctors consider *Lophomonas blattarum* in their differential clinical diagnosis. Since some dust mites are vectors of similar flagellates, whose respiratory manifestations are due to allergy, are similarly presented and are due to lack of an accurate diagnosis, they are transformed

*Expectoration samples stained with Papanicolaou, Hematoxylin and Eosin (H/E) and with Giemsa, respectively. Observed at 400 X. with immersion oil. Note the difference in the observation of the parasites with* 

*each of the staining procedures. Photo Villagrán-Herrera.*

*Two more cases have been added. From Peru and Mexico. It is presumed that in the world, there may be many more* 

**Total 63**

*Reported cases of bronchopulmonary diseases with* Lophomonas blattarum *[5–10].*

*DOI: http://dx.doi.org/10.5772/intechopen.89219*

**5. Conclusions**

**Table 2.**

*cases that have not been reported.*

*Bronchopulmonary Lophomoniasis, Infection by Endocommensal Protozoa of Intradomiciliary… DOI: http://dx.doi.org/10.5772/intechopen.89219*


*Two more cases have been added. From Peru and Mexico. It is presumed that in the world, there may be many more cases that have not been reported.*

#### **Table 2.**

*Parasitology and Microbiology Research*

for the presence of this protozoan.

diagnosis even more difficult.

**4. Discussion**

After the identification of the multiflagellated protozoan, treatment with metronidazole of 500 mg every 8 h was started orally for 7 days, improving symptoms, decreasing dyspnea and continuing with unproductive cough. Control studies are carried out 15 days after the last antiparasitic intake, and the samples were negative

To the cases reported in Peru, China and Spain (**Table 2**), where they found this protozoon in sputum samples, we must add 1 case recorded of a sinusitis in Iran [9], and this one that we are presenting from Mexico, since they have in common denominator deficiencies in the immune system, which makes them extremely sensitive to any infection no matter how mild. It also indicates a possible airborne transmission, with the influence of a humid environment through waste and environmental dust, and that by aspiration, the trophozoites or protozoan cysts can lodge in the bronchopulmonary epithelium, developing the infection with manifestations similar to any bacterial or fungal pulmonary pathology, which makes

Our patient presented with respiratory symptoms that indicated possible miliary tuberculosis or some acute respiratory pathology, since in the expectorant product blood threads were observed in some of the emissions, so that without the saline solution wet study, the differential diagnosis would not have been possible to reach. The immunological commitment of the patient was a crucial and decisive factor for the development of the infection, as self-medication and the lack of an accurate

**Autor(s) y años Caso(s) registrados País** Chen and Meng [26] 1 China Dong et al. [27] 1 China He et al. [28] 2 China Kang et al. [29] 1 China Liu et al. [30] 1 China Liu et al. [31] 1 China Martínez Girón et al. [32] 1 España Martínez Girón & Doganci [33] 1 España Miao et al. [34] 1 China Shi et al. [35] 1 China Wang [36] 26 China Wang et al. [37] 1 China Yang et al. [38] 1 China Yao [39] 1 China Yao et al. [40] 1 China Yao et al. [41] 1 China Yao et al. [42] 1 China Yao et al. [43] 1 China Yao et al. [44] 1 China

diagnosis were important factors to delay his full recovery.

**264**

*Reported cases of bronchopulmonary diseases with* Lophomonas blattarum *[5–10].*
