Evaluating Pulmonary Samples of Immunodeficient Patients for a Free-Living Amoeba: Acanthamoeba in BAL Samples

   Background: Pulmonary disorders caused by parasites are common in many tropical regions. Acanthamoeba is an opportunistic parasite, and most of its dangerous complications are seen in patients with immune deficiencies. Considering the high dissemination of Acanthamoeba parasite in water, soil, and fine airborne dust in Iran, this research was performed to study the rate of pulmonary secretions infection to Acanthamoeba in patients with immune system disorder. Materials and Methods: This cross-sectional study was done in one year (2017 to 2018) in Arak City. The study sample was selected from immunodeficient subjects who had chronic obstructive pulmonary disease, too. The demographic data were also collected from all study samples. The respiratory sample was obtained from each selected patient by Bronchoalveolar Lavage (BAL). Each sample was examined by smear staining, cultivation, and molecular methods. Results: Out of 64 immunocompromised patients investigated in the current research, the Acanthamoeba infection was found in 100%, 98.4%, and 0% of their BAL with culture, molecular, and direct methods, respectively. Conclusion: The outcomes of our research indicated that selecting the diagnostic method in agreement with the kind of sample has a remarkable role in recognizing the contamination. The results of this research showed that the direct microscopy test of Giemsa stained smear was not suitable for detecting this kind of parasitic infection in the BAL sample. Therefore, awareness of the occurrence of Acanthamoebiasis in immunocompromised subjects is essential for preventing the dangerous complications of this parasite.