Isolated Balantidium coli in a 1.5-Year-Old Boy: A Case Report.

PURPOSE: Balantidium coli, is a protozoa that can infect humans. Balantidium coli infection is mostly asymptomatic, but can cause of diarrhea, abdominal pain and sometimes perforated colon. There are only few previous reports regarding the infant balantidiasis and there is a little information about its clinical signs and treatment. In Islamic countries pig farming and consumption is prohibited and reservoir host is unknown. METHODS: 1.5 years old boy showed sever anorexia and diarrhea. The affected infant was depressed. The evaluation of fecal examination revealed a large number of B. coli trophozoites and cysts leaded us to an uncommon presentation of B. coli in the infant. RESULTS: A few reports of human balantidiasis from Iran seems quite extraordinary. Wild boars have been proposed the responsible for transmission of human infection in Iran. CONCLUSION: However, this report as the first report of infant balantidiasis in Iran supports the role of other sources and domestic or wild animals as reservoir hosts for B. coli in Iran.

Prevalence and molecular identification of Balantioides coli isolates from pet guinea pigs in Central China.

Balantioides coli is the only known zoonotic ciliate that can infect humans and is usually acquired from swine. It has, however, been reported in other mammals, including guinea pigs, where infection prevalence and molecular characterization are relatively unknown. In the present study, 32 guinea pigs from two different pet markets in Luoyang city of the Henan province in China were evaluated for ciliate-like trophozoites or cysts by direct fecal smear microscopy. Positive samples were further characterized using 18S rDNA and ITS1-5.8S rDNA-ITS2 sequence analysis. Microscopy indicated that ciliate-like cysts were observed in the fecal samples of several guinea pigs, were spherical in shape, and exhibited sizes of 40-65 µm in diameter. The average cyst-positive prevalence in guinea pigs was 62.5%. Sequence analysis indicated that the guinea pig-derived ciliate isolates belonged to B. coli and included two genetic variants (A and B), of which genetic variant A was more dominant among the guinea pig samples. To the best of our knowledge, the present study is the first molecular identification of B. coli in guinea pigs and provides some important information for investigating the molecular epidemiology of B. coli.

Urinary balantidiasis in a patient with systemic lupus erythematosus and lupus nephritis: a case report.

BACKGROUND: Balantidium coli, a parasitic unicellular ciliate, often causes asymptomatic balantidiasis of the colon, but extraintestinal disease may occur rarely in immunosuppressed individuals. Renal balantidiasis associated with systemic lupus erythematosus has not been reported before. CASE PRESENTATION: We present a case of a 48-year-old Thai woman who presented with nephrotic syndrome due to systemic lupus erythematosus-related nephritis. Initially, few B. coli cysts were found in urine sediment, but these increased substantially following treatment with prednisolone. She made an uneventful recovery with 10 days of oral tetracycline therapy. No B. coli cysts were found in her stool. CONCLUSION: The route of infection in our patient was unclear but is likely to have been orofecal. Neither her infection nor its treatment caused a deterioration in her renal function.

Endoparasitism of Greek ostriches: First report of Entamoeba struthionis and Balantioides coli.

Ostrich farming is a worldwide practice and an internationally developing industry. Among challenges in livestock production are the parasitic infections. The present study aimed to the investigation of the gastrointestinal parasites biota and prevalence in ostriches raised in different areas of Greece. A total of 141 clinically healthy ostriches originating from four different localities of Greece were coprologically examined for parasites of the gastrointestinal tract. Coprological examination revealed a considerably high rate of infection (65.9%) with protozoa; however, no helminths (trematodes, cestodes and nematodes) were detected. In detail, cysts of Entamoeba struthionis have been found in 57.4% of the examined birds. Moreover, 39.0% of sampled ostriches harboured cysts of Balantioides coli (syn. Balantidium coli), while oocysts of Cryptosporidium sp. were detected at a low percentage (2.1%). Partial sequences of the small subunit rRNA (16S rRNA) gene and the ITS region were amplified from pooled Entamoeba and Balantioides positive samples, respectively, confirming for the first time the presence of Entamoeba struthionis and Balantioides coli in ostriches in Greece. Some of these parasitoses require attention as they may affect productivity performance of the animals in commercial ostrich farming and possibly pose disease risk for livestock and humans.

A Comparative Study of Four Methods for the Detection of Nematode Eggs and Large Protozoan Cysts in Mandrill Faecal Material.

Coproscopical methods like sedimentation and flotation techniques are widely used in the field for studying simian gastrointestinal parasites. Four parasites of known zoonotic potential were studied in a free-ranging, non-provisioned population of mandrills (Mandrillus sphinx): 2 nematodes (Necatoramericanus/Oesophagostomum sp. complex and Strongyloides sp.) and 2 protozoan species (Balantidium coli and Entamoeba coli). Different coproscopical techniques are available but they are rarely compared to evaluate their efficiency to retrieve parasites. In this study 4 different field-friendly methods were compared. A sedimentation method and 3 different McMaster methods (using sugar, salt, and zinc sulphate solutions) were performed on 47 faecal samples collected from different individuals of both sexes and all ages. First, we show that McMaster flotation methods are appropriate to detect and thus quantify large protozoan cysts. Second, zinc sulphate McMaster flotation allows the retrieval of a higher number of parasite taxa compared to the other 3 methods. This method further shows the highest probability to detect each of the studied parasite taxa. Altogether our results show that zinc sulphate McMaster flotation appears to be the best technique to use when studying nematodes and large protozoa.

Occurrence, clinical involvement and zoonotic potential of endoparasites infecting Swiss pigs.

In order to estimate the diversity, clinical involvement and zoonotic potential of parasites in pigs submitted for diagnosis to the PathoPig project of the Swiss Federal Food Safety and Veterinary Office, faeces (n=125) from suckling piglets (n=39), weaners (n=60) and piglets beginning fattening (n=26) from 74 Swiss farms were examined by 3 coproscopical methods (i.e. sedimentation/zinc chloride-flotation; SAFC and Ziehl-Neelsen staining). Samples microscopically positive for Cryptosporidium were further tested by PCR/sequencing for species assessment. The most frequently detected parasite was Balantidium coli, a facultative pathogenic ciliate with zoonotic potential, in 5.1, 36.7 and 50.0% of suckling, weaners and fatteners and 43.2% of farms; however, no association with disease was observed. Isospora (syn. Cystoisospora) suis infections were detected in 13.3 and 11.1% of suckling piglets with and without diarrhoea, and in 10.0 and 13.3% of weaners and fatteners with diarrhoea, respectively, and were significant associated with emaciation. Cryptosporidium infections were detected in 10.3, 15.0 and 19.2% of sucklings, weaners and fatteners, respectively, and in 18.9% of the farms. Interestingly, two age-related species were identified: C. suis in younger piglets (2 to 6weeks) and C. scrofarum in older ones (6 to 17weeks). None of the pigs infected with C. scrofarum (n=8), but 3 of 4 piglets infected with C. suis (co-infection with I. suis in 2 cases) had diarrhoea. The zoonotic species C. parvum was not detected, nevertheless, sporadic cases of human infection with the porcine-adapted species have been reported. Ascaris suum, Trichuris suis and Strongylida were rarely detected (<4%) in all age categories.

Endoparasite survey of free-swimming baleen whales (Balaenoptera musculus, B. physalus, B. borealis) and sperm whales (Physeter macrocephalus) using non/minimally invasive methods.

A number of parasitic diseases have gained importance as neozoan opportunistic infections in the marine environment. Here, we report on the gastrointestinal endoparasite fauna of three baleen whale species and one toothed whale: blue (Balaenoptera musculus), fin (Balaenoptera physalus), and sei whales (Balaenoptera borealis) and sperm whales (Physeter macrocephalus) from the Azores Islands, Portugal. In total, 17 individual whale fecal samples [n = 10 (B. physalus); n = 4 (P. macrocephalus); n = 2 (B. musculus); n = 1 (B. borealis)] were collected from free-swimming animals as part of ongoing studies on behavioral ecology. Furthermore, skin biopsies were collected from sperm whales (n = 5) using minimally invasive biopsy darting and tested for the presence of Toxoplasma gondii, Neospora caninum, and Besnoitia besnoiti DNA via PCR. Overall, more than ten taxa were detected in whale fecal samples. Within protozoan parasites, Entamoeba spp. occurred most frequently (64.7%), followed by Giardia spp. (17.6%) and Balantidium spp. (5.9%). The most prevalent metazoan parasites were Ascaridida indet. spp. (41.2%), followed by trematodes (17.7%), acanthocephalan spp., strongyles (11.8%), Diphyllobotrium spp. (5.9%), and spirurids (5.9%). Helminths were mainly found in sperm whales, while enteric protozoan parasites were exclusively detected in baleen whales, which might be related to dietary differences. No T. gondii, N. caninum, or B. besnoiti DNA was detected in any skin sample. This is the first record on Giardia and Balantidium infections in large baleen whales.

Isolation and maintenance of Balantidium coli (Malmsteim, 1857) cultured from fecal samples of pigs and non-human primates.

Balantidium coli is a protozoa that can determine dysentery in humans, pigs and non-human primates having zoonotic potential. The lack of standardization in isolation and maintenance hinders the development of research on its biology and epidemiology. This study is aimed to standardize the isolation and maintenance of this parasite from animal feces, in culture medium, Pavlova modified. From 2012 to 2014, 1905 fecal samples were collected from captive animals of Rio de Janeiro. Were selected for isolation samples with a minimum of 10 trophozoites and/or 30 cysts of B. coli, totaling 88 pigs, 26 Cynomolgus and 90 rhesus macaques. In the presence of cysts, the sample was homogenized in saline solution, 500 µL was removed and inoculated into culture medium. The material that contained trophozoites the inoculum was made from 240 µL of fecal solution. All inoculate tubes with the subcultures were kept at 36°C, and sterile rice starch was always added to the medium. The parasites isolate from pigs, 34%, and from Cynomolgus 38.4% were maintained in vitro for a period of more than 24 months. These procedures proved to be adequate for isolation and maintenance of B. coli from different animals, they were found to be inexpensive and easy to perform.

New insights into the molecular phylogeny of Balantidium (Ciliophora, Vetibuliferida) based on the analysis of new sequences of species from fish hosts.

We obtained sequences of the small subunit ribosomal RNA (rRNA) for two new isolates of Balantidium from fishes, Balantidium polyvacuolum and Balantidium ctenopharingodoni. This is the first introduction of molecular data of Balantidium species from fish hosts in the phylogenetic analyses of the ciliate subclass Trichostomatia. Despite the fact that these species share morphological characteristics common to other species of Balantidium, the phylogenetic analysis of their sequences has shown that they are to be placed in a different branch closely related to the so-called Australian clade. Thus, our results indicate that the genus Balantidium is polyphyletic and possibly should be represented by two different genera; however, the analysis of more species from other poikilothermic hosts (amphibians, reptiles) should be made before a revised taxonomical proposal could be made.

Gastrointestinal parasites of birds in zoological gardens in south-west Nigeria.

Infections with gastrointestinal parasites are a major health issue in captive birds. However, prevalence data of gastrointestinal parasites of birds in zoological gardens in Nigeria are scarce. This study was carried out to establish the gastrointestinal parasite profile of birds kept in zoological gardens in the University of Ibadan, Obafemi Awolowo University, University of Ilorin, University of Lagos and Federal University of Agriculture Abeokuta, all in south-west Nigeria. A total of 178 fecal samples from 83 birds (14 species in eight orders) were examined using three techniques; Feacal sedimentation using ethyl acetate, McMaster Egg Counting Technique and Petri Dish-Filter Paper Slant culture technique (modified Harada-Mori Technique). A total of 39(21.9%) of the 178 samples were infected. The highest prevalence (100%) of infection was recorded in Unilag zoo and a total of five species of parasites including two protozoans (coccidian and Balantidium spp.); and three nematodes Capillaria spp., Ascaris spp. and Strongyloides spp.) were recorded with Capillaria spp. (14.1%) as the most prevalent gastrointestinal parasite. Mixed infections were found in 18(10.1%) samples. Strongyloides larvae were observed in 6(3.4%) samples. All Anseriformes were infected but the Struthioniformes had the highest infection rate. The geometric mean intensity of eggs ranged from 101.98 ± 10.36 to 63.00 ± 16.67 epg and oocyst counts ranged from 332.47 ± 16.67 to 297.89 ± 20.41 opg. Balantidium cyst count was 324.04 ± 25.00. Count of oocyst of coccidian species was significantly higher in all the zoos. The feacal culture yielded Strongyloides species. Regular deworming and hygienic measures are necessary to prevent gastrointestinal infections in captive birds. So also, improved funding and management are necessary to ensure sustainability of Nigerian zoological gardens.

Novel insights into the genetic diversity of Balantidium and Balantidium-like cyst-forming ciliates.

Balantidiasis is considered a neglected zoonotic disease with pigs serving as reservoir hosts. However, Balantidium coli has been recorded in many other mammalian species, including primates. Here, we evaluated the genetic diversity of B. coli in non-human primates using two gene markers (SSrDNA and ITS1-5.8SDNA-ITS2). We analyzed 49 isolates of ciliates from fecal samples originating from 11 species of captive and wild primates, domestic pigs and wild boar. The phylogenetic trees were computed using Bayesian inference and Maximum likelihood. Balantidium entozoon from edible frog and Buxtonella sulcata from cattle were included in the analyses as the closest relatives of B. coli, as well as reference sequences of vestibuliferids. The SSrDNA tree showed the same phylogenetic diversification of B. coli at genus level as the tree constructed based on the ITS region. Based on the polymorphism of SSrDNA sequences, the type species of the genus, namely B. entozoon, appeared to be phylogenetically distinct from B. coli. Thus, we propose a new genus Neobalantidium for the homeothermic clade. Moreover, several isolates from both captive and wild primates (excluding great apes) clustered with B. sulcata with high support, suggesting the existence of a new species within this genus. The cysts of Buxtonella and Neobalantidium are morphologically indistinguishable and the presence of Buxtonella-like ciliates in primates opens the question about possible occurrence of these pathogens in humans.

Occurrence and molecular analysis of Balantidium coli in mountain gorilla (Gorilla beringei beringei) in the Volcanoes National Park, Rwanda.

Cysts morphologically resembling Balantidium coli were identified in the feces of a mountain gorilla (Gorilla beringei beringei). Confirmatory PCR and sequencing revealed two distinct B. coli-specific sequences (ITS-1, sub-types A0 and B1). This represents the first report of B. coli in this species, raising the possibility of infection from a reservoir host.

Balantidium coli-induced pulmonary haemorrhage with iron deficiency.

BACKGROUND: Balantidium coli, a ciliated protozoan parasite that infects primates and pigs, and is the largest protozoan to infect humans, is a well-known cause of diarrhoea and dysentery in humans. Extra-intestinal disease is uncommon, however. OBJECTIVE: We describe a case of lung involvement, with severe pulmonary haemorrhage resulting in iron deficiency anaemia and respiratory failure, of a 20-year-old, immune-competent man. RESULTS: Diagnosis was made by bronchial biopsy and lavage, which showed numerous trophozoites compatible with B. coli with a background of acute inflammatory cells. The origin of infection was not clear, but inhalation of pig manure was postulated as there was no history of intestinal disease. The patient was treated with oxytetracyline and metronidazole, kept in an ICU, improved within 48 hours, and was discharged within 4 days. CONCLUSION: B. coli infection should be considered as part of the differential diagnosis of pulmonary haemorrhage.

Investigation of intestinal parasites in pig feces that are also human pathogens.

A total of 238 pig fecal specimens were collected from pig farms in Corlu (Tekirdag), Ayazma, and Arnavutköy (Istanbul) during the summer. Out of the 238 pig specimens, 105 were from pigs younger than 6 months and 133 from pigs older than 6 months. These were investigated for intestine parasites in particular the ones that are human pathogens. Cryptosporidium spp. was detected In 21 fecal specimens (8.8%), Giardia spp. in 9 (3.7%), Balantidium coli cysts in 4 (1.6%) and Ascaris suum eggs in 9 (4.1%). Giardia lamblia were found in 8 (7.6%) of 105 pigs younger than 6 months, Cryptosporidium spp. in 12 (11.4%), Balantidium coli cysts in 2 (1.5%). In the pigs older than 6 months Giardia lamblia were found in 1 (0.7%), Cryptosporidium spp. in 9 (6.7%), Balantidium coli cysts in 2 (1.5%). and Ascaris suum eggs in 9 (6.7%). The difference in the rate of G. lamblia (p=0.01) in pigs less than 6 months and of A. suum in those over 6 months was found to be statistically significant (p=0.005). Our results revealed that pigs are important sources of these parasites.

Dysentery caused by Balantidium coli in a patient with non-Hodgkin's lymphoma from Turkey.

Balantidium coli is the only parasitic ciliate of man. It is a flattened oval organism covered with cilia, and a gullet at the anterior end. It is infrequently pathogenic for man, although epidemic buds in tropical zones have been described. The infection fundamentally affects the colon and causes variable clinic pictures, from asymptomatic to serious dysenteric forms. We present a case of parasitologically diagnosed as causes of diarrhea in a patient with non-Hodgkin's lymphoma from Turkey. In order to find out the causative etiologic agent of diarrhea, stool samples were examined by native, lugol and flotation methods and we detected moving trophozoites, which were approximately 60 microm long and 35 microm wide. These bodies were diagnosed as Balantidium coli. This case underlines that Balantidium coli should also be considered as a possible pathogen in immunocompromised patients with diarrhea.

Age-dependent occurrence of the intestinal ciliate Balantidium coli in pigs at a Danish research farm.

A cross sectional study of the prevalence and intensity of Balantidium coli in pigs was carried out on a Danish research farm. The prevalence of B. coli infection increased from 57% in suckling piglets to 100% in most pig groups > or = 4 weeks old. The mean number of cysts per gram faeces (CPG) of pigs aged 12 weeks and younger were < or = 206, whereas pigs aged 28 weeks and > 52 weeks had significantly higher counts of > or = 865 CPG. Although some lactating sows had very high CPG's, no significant differences in CPG could be detected between the intensities of pregnant sows, lactating sows and empty and dry sows. No human cases of B. coli infection have been published in Denmark though it is zoonotic.

[Colonic balantidiasis]. / Balantidiasis cólica.

Balantidium coli is a Protozoa that is not usually pathogenic in man, although epidemics have been described in tropical areas. It mainly affects the colon and clinical presentation varies from asymptomatic forms to severe dysenteric syndromes. We present a case of endoscopically diagnosed colonic balantidiasis and review the most important characteristics of this parasite-induced disease.