Abstract
BackgroundTrichomonas tenax may appear in the oral cavity of humans due to poor dentition or oral hygiene. Pyopneumothorax is a serious complication of lower respiratory tract infections that very rarely can be caused by a trichomonad species in predisposed individuals. We report a rare case of pleurisy due to T. tenax with coinfection by a fungus.Case presentationWe describe a 16-year-old patient with cerebral palsy who presented with severe pyopneumothorax. T. tenax was identified by microscopic examination of the pleural effusion and next-generation sequencing. We also identified Geotrichum capitatum in the pleural effusion and bronchoalveolar lavage fluid cultures. Treatment with voriconazole and metronidazole successfully eliminated these pathogens and relieved the clinical symptoms. A literature review indicated this is the first reported case of pleurisy due to T. tenax with coinfection by a fungus.ConclusionThe rarity of pyopneumothorax caused by T. tenax coinfection with a fungus should not be overlooked in the clinic. These patients should be and treated in a timely manner.
Highlights
Trichomonas tenax may appear in the oral cavity of humans due to poor dentition or oral hygiene
The rarity of pyopneumothorax caused by T. tenax coinfection with a fungus should not be overlooked in the clinic
We describe a patient with pyopneumothorax with coinfection by T. tenax and Geotrichum capitatum, a saccharomycete fungus formerly known as Trichosporon capitatum or Brastochizomyces capitatus
Summary
Trichomonas tenax may appear in the oral cavity of humans due to poor dentition or oral hygiene. There are only 7 reported cases of T. tenax infection and pleural empyema in the English-language medical literature to date [1,2,3,4,5,6,7]. Direct microscopy of a wet smear cytocentrifuged preparation created with 100 μL of the pleural fluid sediment indicated motile and flagellated organisms that were 8–10 μm in length.
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