Balantidiasis

From WikiProjectMed
Jump to navigation Jump to search
Balantidiasis
Other names: Ciliary dysentery[1][2]
  • Top:Balantidium coli as seen in a wet mount of a stool specimen. The organism is surrounded by cilia.
  • Bottom: Balantidiasis life cycle[3]
SpecialtyInfectious disease
SymptomsAsymptomatic or diarrhea, abdominal pain, nausea, vomiting[1]
ComplicationsPerforation of the colon, peritonitis[3]
CausesBalantidium coli[1]
Diagnostic methodStool samples[1]
TreatmentMetronidazole or tetracycline[1]

Balantidiasis is a protozoan infection caused by infection with Balantidium coli (Balantidium coli infection[4]).[5]It can cause an intestinal infection, though it is relatively rare in humans but can be acquired by ingesting contaminated food or water, often in areas where pigs are raised[6]

The antibiotic drug used to treat Balantidiasis is tetracycline in the affected individual[1]

As to the epidemiology of Balantidiasis we find that it is common in tropical and subtropical regions, such as Latin America, the Philippines, and Papua New Guinea.[7]

Symptoms and signs

Usually asymptomatic in immunocompetent individuals, but the symptoms of balantidiasis include:[1][8]

Complications

As to the complications of Balantidiasis we find:[3]

Cause

Balantidium coli is a parasitic species of ciliate alveolates, it is the only member of the ciliate phylum known to be pathogenic to humans.[9]

Morphology

Urinary sediment- trophozoites of Balantidium

Balantidium coli exists in either of two developmental stages: trophozoites and cysts.[10] In the trophozoite form, they can be oblong or spherical, and are typically 30 to 150 µm in length and 25 to 120 µm in width.[11] It is its size at this stage that allows Balantidium coli to be characterized as the largest protozoan parasite of humans.[10] Trophozoites possess both a macronucleus and a micronucleus, and both are usually visible.[10] The macronucleus is large and sausage-shaped while the micronucleus is less prominent.[11] At this stage, the organism is not infective but it can replicate by transverse binary fission.[10]

In its cyst stage, the parasite takes on a smaller, more spherical shape, with a diameter of around 40 to 60 µm.[11] Unlike the trophozoite, whose surface is covered only with cilia, the cyst form has a tough wall made of one or more layers. The cyst form also differs from the trophozoite form because it is non-motile and does not undergo reproduction. Instead, the cyst is the form that the parasite takes when it causes infection.[10]

Transmission

Balantidium is the only ciliated protozoan known to infect humans. Balantidiasis is a zoonotic disease and is acquired by humans via the feco-oral route from the normal host, the pig, where it is asymptomatic. "Contaminated water is the most common mechanism of transmission. Equally dangerous, however, is the ingestion of contaminated food."[12]

Diagnosis

The diagnosis of balantidiasis can be an intricate process, partly because the related symptoms may or may not be present. However, the diagnosis of balantidiasis can be considered when a patient has diarrhea combined with a probable history of current exposure to pigs (since pigs are the primary reservoir), contact with infected persons. In addition, the diagnosis of balantidiasis can be made by microscopic examination of stools in search of trophozoites or cysts, or colonoscopy or sigmoidoscopy to obtain a biopsy from the large intestines which may provide evidence for the presence of trophozoites.[13][14][1]

Dfferential diagnosis

Ulcerative colitis

In terms of the DDx in an affected individual we find the following:[15][1]

Prevention

Preventative measures require effective personal and community hygiene. Some specific safeguards include the following:[16][5]

  • Purification of drinking water.
  • Proper handling of food.
  • Careful disposal of human feces.

Treatment

Tetracycline

In terms of management in an affected individual we find that Balantidiasis can be treated with tetracycline,as well as, metronidazole or iodoquinol.[17][1]

Epidemiology

In terms of the epidemiology of Balantidiasis we find that it is most common in tropical and subtropical regions, such as in Latin America, the Philippines, Papua New Guinea, as well as the Middle East. While a global disease, prevalence in humans is low in at-risk populations.[7][5]

Currently, Balantidium coli is distributed worldwide but less than 1% of the human population is infected.[18][11] Pigs are a major reservoir of the parasite, and infection of humans occurs more frequently in areas where pigs comingle with people.[18] This includes places like the Philippines, as previously mentioned, but also includes countries such as Bolivia.[18][19] But pigs are not the only animal where the parasite is found. For example, Balantidium coli also has a high rate of incidence in rats.[20] In a Japanese study that analyzed the fecal samples in 56 mammalian species, Balantidium coli was found to be present not just in all the wild boars tested , it was also found in five species of non human primate: Chimpanzee , White-handed gibbon, Squirrelmonkey, Sacred baboon, and Japanese macaque.[21] In other studies, Balantidium coli was also found in species from the orders Rodentia and Carnivora.[21]

History

Balantioides coli was first discovered by Swedish physician Fredrik Malmsten in 1857 when he identified it in patients suffering from acute dysentery. His work was the foundation for the study of protozoan and role in human infections.[22]

The first study to generate balantidiasis in humans was undertaken by Cassagrandi and Barnagallo in 1896.[23] However, this experiment was not successful in creating an infection and it was unclear whether Balantidium coli was the actual parasite used.[23] The first case of balantidiasis in the Philippines, where it is the most common, was reported in 1904.[24][11]

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 "Balantidiasis - Symptoms, Causes, Treatment | NORD". rarediseases.org. Retrieved 4 April 2025.
  2. ↑ "Balantidiasis | About the Disease | GARD". rarediseases.info.nih.gov. Archived from the original on 12 November 2019. Retrieved 4 April 2025.
  3. ↑ 3.0 3.1 3.2 "Balantidiasis". www.cdc.gov. 7 June 2019. Archived from the original on 14 August 2019. Retrieved 12 April 2025.
  4. ↑ "Balantidiasis (Concept Id: C0004692) - MedGen - NCBI". www.ncbi.nlm.nih.gov. Retrieved 8 May 2025.
  5. ↑ 5.0 5.1 5.2 Schuster, Frederick L.; Ramirez-Avila, Lynn (October 2008). "Current world status of Balantidium coli". Clinical Microbiology Reviews. 21 (4): 626–638. doi:10.1128/CMR.00021-08. ISSN 1098-6618. PMC 2570149. PMID 18854484.
  6. ↑ "Balantidiasis: Background, Pathophysiology, Epidemiology". eMedicine. 28 February 2025. Retrieved 7 April 2025.
  7. ↑ 7.0 7.1 Kelly, Paul; Siwila, Joyce (1 January 2024). "55 - Intestinal Protozoa". Manson's Tropical Diseases (Twenty-Fourth ed.). Elsevier. pp. 681–697. ISBN 978-0-7020-7959-7.
  8. ↑ da Silva, Rayana Katylin Mendes; Dib, Laís Verdan; Amendoeira, Maria Regina; Class, Camila Carvalho; Pinheiro, Jessica Lima; Fonseca, Ana Beatriz Monteiro; Barbosa, Alynne da Silva (November 2021). "Balantidiasis in humans: A systematic review and meta-analysis". Acta Tropica. 223: 106069. doi:10.1016/j.actatropica.2021.106069. PMID 34339668.
  9. ↑ Ramachandran, Ambili (23 May 2003). "Introduction". The Parasite: Balantidium coli The Disease: Balantidiasis. ParaSite. Stanford University. Archived from the original on 14 April 2013. Retrieved 10 February 2023.
  10. ↑ 10.0 10.1 10.2 10.3 10.4 Ramachandran, Ambili. "Morphology." The Parasite: Balantidium coli The Disease: Balantidiasis. 23 May 2003. Stanford University. 16 May 2009 http://www.stanford.edu/group/parasites/ParaSites2003/Balantidium/Morphology.htm Archived 2013-04-14 at the Wayback Machine
  11. ↑ 11.0 11.1 11.2 11.3 11.4 Roberts, Larry S., and John Janovy Jr. Gerald D. Schmidt & Larry S. Roberts' Foundations of Parasitology. 8th ed. New York: McGraw-Hill, 2009.
  12. ↑ Dwight D., Bowman (December 9, 2013). Georgi's Parasitology For Veterinarians. St. Louis, MO: Elsevier Saunders.: Saunders; 10 edition.
  13. ↑ Ferry T, Bouhour D, De Monbrison F, et al. (May 2004). "Severe peritonitis due to Balantidium coli acquired in France". Eur. J. Clin. Microbiol. Infect. Dis. 23 (5): 393–5. doi:10.1007/s10096-004-1126-4. PMID 15112068. S2CID 20552666.
  14. ↑ Walzer PD, Judson FN, Murphy KB, Healy GR, English DK, Schultz MG (January 1973). "Balantidiasis outbreak in Truk". Am. J. Trop. Med. Hyg. 22 (1): 33–41. doi:10.4269/ajtmh.1973.22.33. PMID 4684887.
  15. ↑ "Diarrhea: Practice Essentials, Background, Pathophysiology". eMedicine. 28 February 2024. Archived from the original on 3 April 2025. Retrieved 9 April 2025.
  16. ↑ "About Balantidium coli infection". Balantidium coli. 4 September 2024. Retrieved 11 April 2025.
  17. ↑ "Balantidiasis: Treatment & Medication - eMedicine Infectious Diseases". Archived from the original on 25 February 2009. Retrieved 2009-02-24.
  18. ↑ 18.0 18.1 18.2 "Parasites and Health: Balantidiasis Balantidium coli". Archived from the original on December 3, 2013.
  19. ↑ Ramachandran, Ambili (23 May 2003). "Epidemiology of Balantidiasis". The Parasite: Balantidium coli The Disease: Balantidiasis. Stanford University. Archived from the original on 14 June 2009. Retrieved 16 May 2009.
  20. ↑ Prevention, CDC - Centers for Disease Control and. "CDC - Balatidiasis - Biology". www.cdc.gov. Archived from the original on 2018-04-27. Retrieved 2018-04-27.
  21. ↑ 21.0 21.1 Nakauchi, Kiyoshi. "The Prevalence of Balantidium coli Infection in Fifty-Six Mammalian Species." Journal of Veterinary Medical Science 61 (1999): 63-65.
  22. ↑ Despommier, Dickson D.; Gwadz, Robert W.; Hotez, Peter J. (1995). "Balantidium coli (Malmsten 1857)". Parasitic Diseases. Springer. pp. 159–162. ISBN 978-1-4612-2476-1. Archived from the original on 2018-06-05. Retrieved 2025-05-08.
  23. ↑ 23.0 23.1 McCarey AG (March 1952). "Balantidiasis in South Persia". Br Med J. 1 (4759): 629–31. doi:10.1136/bmj.1.4759.629. PMC 2023172. PMID 14905008.
  24. ↑ Mason CW (1919). "A Case of Balantidium coli Dysentery". Journal of Parasitology. 5 (3): 137–138. doi:10.2307/3271167. JSTOR 3271167. Archived from the original on 2021-09-04. Retrieved 2021-09-04.

External links

Classification
External resources
Retrieved from "https://mdwiki.org/w/index.php?title=Balantidiasis&oldid=1466625"