A Lophomonas infection mimicking Angina: An extremely rare case report

Background: Lophomonas is a non-aerobic protozoan parasite. This parasite has the ability to invade the respiratory tract. It presents with non-specific clinical manifestations. The gold standard for diagnosis is microscopic examination. The drug of choice for the treatment is Metronidazole. We report a rare case of Lophomonas infection that manifested with a dry cough and chest tightness, which was not reported in the medical literature previously. Case presentation : We report the case of a 45-year-old asian male who experienced episodes of chest tightness and cough. He showed elevated numbers of Eosinophils and IGE. A bronchoscopy was performed to investigate the presence of elevated Eosinophils in the bronchoalveolar lavage (BAL). The microscopic examination of BAL detected a parasite with flagella. The Giemsa staining procedure confirmed the diagnosis of Lophomonas. He was cured with Metronidazole. Now the patient is in good condition. Conclusions: Even if Lophomonas is a rare and unexpected diagnosis, we should keep it in mind as a probable cause in patients with unspecific manifestations and radiological and laboratory investigations. In addition, biosecurity procedures should be taken especially in endemic regions and workplaces.