Background: lophomonas blattarum is a protozoan, which is controversial regarding pathogenicity in the respiratory disease, and identification methods. This study investigated the presence of this protozoan in patients admitted to the intensive care unit (ICU) to assess these controversies. Materials and Methods: Samples of 83 patients hospitalized in the ICU ward of Afzalipoor, Shafa, and Shahid Bahonar hospitals (Kerman, Iran) were collected. The samples were examined using microscopy and real-time polymerase chain reaction (PCR) to check the presence of lophomonas blattarum. Then, the efficiency of the method used was investigated using bioinformatics studies and the presence of trichomonas tenax in the samples was investigated. Results: Of 83, 38 (46%) were female, 45 (54%) were male, and their age was 46. 6 ± 14. 45 years. Microscopic examination did not show any in the samples. The real-time PCR method showed 16 positive samples with primers that had been reported in other studies for lophomonas blattarum. The bioinformatics study showed the method introduced in the other studies lacks the efficiency and specificity, and there is no information in the databases to design a molecular method based on the PCR for identification of lophomonas blattarum. The results of examining the presence of trichomonas tenax using the real-time PCR method showed that 16 samples with a positive result for Lofomonas blattarum contained trichomonas tenax, which indicated that a misidentification had probably occurred. Conclusion: The current methods that are used to identify lophomonas blattarum do not have the sensitivity and specificity required to identify this protozoan.

Background: lophomonas blattarum is a protozoan, which is controversial regarding pathogenicity in the respiratory disease, and identification methods. This study investigated the presence of this protozoan in patients admitted to the intensive care unit (ICU) to assess these controversies. Materials and Methods: Samples of 83 patients hospitalized in the ICU ward of Afzalipoor, Shafa, and Shahid Bahonar hospitals (Kerman, Iran) were collected. The samples were examined using microscopy and real-time polymerase chain reaction (PCR) to check the presence of lophomonas blattarum. Then, the efficiency of the method used was investigated using bioinformatics studies and the presence of trichomonas tenax in the samples was investigated. Results: Of 83, 38 (46%) were female, 45 (54%) were male, and their age was 46. 6 ± 14. 45 years. Microscopic examination did not show any in the samples. The real-time PCR method showed 16 positive samples with primers that had been reported in other studies for lophomonas blattarum. The bioinformatics study showed the method introduced in the other studies lacks the efficiency and specificity, and there is no information in the databases to design a molecular method based on the PCR for identification of lophomonas blattarum. The results of examining the presence of trichomonas tenax using the real-time PCR method showed that 16 samples with a positive result for Lofomonas blattarum contained trichomonas tenax, which indicated that a misidentification had probably occurred. Conclusion: The current methods that are used to identify lophomonas blattarum do not have the sensitivity and specificity required to identify this protozoan.

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.

Background: Allergic rhinitis (AR) is one of the most common allergic diseases triggered by indoor and outdoor allergens. Certain arthropods, such as mites and cockroaches, contain protozoa like lophomonas blattarum in their intestines to help with digestion that may have some role in AR. We aimed to determine the frequency of L. blattarum in nasal smears of patients with AR in comparison with healthy controls. Methods: In this prospective cross-sectional study (March 2015-March 2016), 36 patients with a clinical presentation of AR (with a positive prick test including mites) and 34 normal controls were included at ear, nose, and throat (ENT) clinic at Imam Reza Hospital of Mashhad, Iran. Nasal secretions were evaluated to examine presence of L. blattarum in the patients and control group by direct method. Diagnosis of L. blattarum was based on microscopic observation both on direct smear and Giemsa stained specimens. Results: Patients with AR had a higher frequency of L. blattarum in their nasal smears than the control group (25% vs. 2. 9%) (P=0. 001). Conclusion: We found L. blattarum more frequently in the nasal secretion of AR patients compared with healthy subjects,this protozoon may have some role in this condition. However, the relationship between L. blattarum and AR requires further studies to allow a greater understanding.

Background: lophomonas blattarum is protozoan generally parasitizes in the intestinal tracts of some arthropods. It can infect adults and children with unspecific respiratory symptoms. We aimed to investigate the frequency of lophomonas blattarum in children with respiratory symptoms in North East of Iran.Materials and Methods: One hundred fifty-six children with respiratory symptoms were investigated in a descriptive-analytical study using Bronchoalveolar lavage (BAL) according to enumeration method in March 2016 to March 2017. Data was collected via a check list, prospectively. All had Bronchoscopy and chest X-ray. The data were analyzed using SPSS program.Results: Of the 156 studied children, 40.4% (n=63) of patients with the average age of 5.11±2.9 years were positive for L. blattarum infection. In positive cases, 42.9% (n=27) were male. There was a significant relationship between gender and lophomonas infection (p=0.0006). The most common respiratory symptoms were cough, fever, wheeze and tachypnea. Radiography of infected patients showed pulmonary infiltration (16.7%), unilateral lung hyperinflation (23.1%), consolidation (19.9%), and lung collapse (14.7%). Underlying diseases were detected in 4 infected patients. Bronchoscopy showed abnormal results in 22 patients (14.1%). Most common abnormalities were in order: mucus plaque (22.7%), left bronchomalacia (18.2%), left bronchial stenosis (18.2%) and foreign body aspiration (13.6%).Conclusion: Generally, 40.4% of children with respiratory symptoms were positive for L. blattarum infection. It is suggested to consider L. blattarum as a cause of pulmonary infections in patients with pulmonary symptoms.

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.