Balantioides coli.

Balantioides coli (=Balantidium coli) is the only ciliate that parasitizes humans. Pigs are the main reservoir. Other species, as camels, cattle, donkey, sheep and goat have been also proposed as reservoirs for human infections. The parasite has a direct life cycle, being transmitted by the faecal-oral route. This type of cycle and the large number of host species imply an important potential for zoonotic transmission of the parasite. Infections are most commonly found in tropical and temperate regions, with prevalence up to 100% in pigs; high prevalence values have been also recorded in some non-human primates and camels. In humans, prevalence is usually under 10% in the population at risk. The main epidemiological factors involved in the transmission of this parasite include close contact with pigs, lack of basic sanitation infrastructures (water supply, wastewater disposal) and hygiene. Individual health status, intestinal microbiota and diet are also important for the onset of the infection. Outbreaks caused by this parasite are rare; those reported to date were related to poor hygienic conditions or to catastrophic natural disasters. Balantioides coli infections can be asymptomatic and symptomatic, which can be chronic (with intermittent diarrhoea), or acute (a dysenteric form which can be life-threatening). Efective treatments include tetracycline, iodoquinol and 5-nitroimidazole compounds (metronidazole, secnidazole). The main effective individual preventive measure is the use of disinfected water for drinking and other uses. Adequate water supply infrastructures, proper disposal of wastewater and animal faeces, and regular monitoring programs on farms will help limit transmission.

[Colonic balantidiasis: report of a fatal case and review of the literature]. / Balantidiasis colónica: reporte de un caso fatal y revisión de la literatura.

Balantidiasis is a zoonosis produced by Balantidium coli, which inhabits the large intestine of the pig and man. Infection is uncommon in humans and mainly affects the colon. It occurs more frequently in developing countries, tropical and subtropical regions. Colonic balantidiasis can occur in most cases asymptomatically and reach in the most severe cases such as dysenteric diarrhea that can be complicated by low digestive bleeding and even perforation. We present the case of a 72-year-old man, from the Peruvian highlands, who was a farmer and breeder of swine and sheep, who came for 3 months of illness, initially characterized by liquid stools with bloodless mucus, abdominal pain, nausea, vomiting and in the last month of illness he presents dysenteric diarrhea. Colonoscopy was performed due to suspicion of infectious colitis, Balantidium coli trophozoites were found in the fresh sample and colonic tissue biopsy. Patient receives treatment with amebicide and antibacterial without clinical improvement, presenting as a complication multiple perforation in the sigmoid colon, treated with resection and terminal colostomy. Finally, the patient died despite receiving medical and surgical treatment.

Balantidium coli: an unrecognized cause of vertebral osteomyelitis and myelopathy.

Balantidium coli is a ciliated protozoan parasite that primarily infects primates and pigs. It is the largest protozoan to infect humans and is a well-known cause of diarrhea and dysentery. Extraintestinal disease is uncommon, and extraintestinal spread to the peritoneal cavity, appendix, genitourinary tract, and lung has rarely been reported. The authors describe a case of vertebral osteomyelitis with secondary cervical cord compression caused by B. coli. The patient was a 60-year-old immunocompetent man presenting with quadriplegia of short duration. Magnetic resonance imaging of the cervical spine showed extradural and prevertebral abscess at the C3-4 level. Drainage of the abscess, C3-4 discectomy, and iliac bone grafting were performed. Histologically B. coli was confirmed in an abscess sample. To the best of the authors' knowledge, involvement of bone by B. coli has never been reported, and this case is the first documented instance of cervical cord compression due to B. coli osteomyelitis of the spine in the literature.

Balantidiasis en niños: reporte de un caso fatal / Balantidiasis in children: report of a fatal case

Se presenta un caso de balantidiasis fulminante en una niña, procedente de Zarumilla-Tumbes, portadora de colostomía por malformación anorrectal y desnutrición crónica. Las manifestaciones clínicas fueron diarrea disentérica, vómitos y deshidratación, evolucionando con signos de sepsis y abdomen agudo. El diagnóstico de balantidiasis se realizó mediante exámen directo de heces, y el tratamiento inicial con metronidazol y cobertura antibiótica. Ante el curso desfavorable se utilizó tetraciclinas, pero dada su condición de inmunosupresión la paciente fallece. Debemos de considerar esta entidad ante la presencia de las manifestaciones clínicas señaladas en personas que proceden de la frontera con el Ecuador, realizar examen de heces e iniciar tratamiento de primera elección (tetraciclinas), valorando el riesgo-beneficio.

Flagellates and ciliates.

This article includes information on two human parasites, one protozoan flagellate, Giardia lamblia, and one ciliate, Balantidum coli. Both are transmitted through ingestion of food and water contaminated with fecal material. G. lamblia may be the most common intestinal protozoan found in humans throughout the world and causes a wide range of symptoms, all of which can be confused with other infectious and noninfectious causes. Although B. coli tends to be more restricted and associated with pigs as potential reservoir hosts, this organism can also cause mild to severe symptoms and can be found throughout the world.

Geophagy as a therapeutic mediator of endoparasitism in a free-ranging group of rhesus macaques (Macaca mulatta).

Parasite levels were determined for 141 members of a naturally formed social group of rhesus macaques living under free-ranging conditions. Results indicate that group members harbor Trichuris trichiura, Balantidium coli, and large numbers of Strongyloides fuelleborni. Parasite counts decrease significantly with age in this population. Females have significantly fewer parasites than males and a significantly lower prevalence of multiple infections. There were no rank effects regarding parasitosis. While 89% of the animals examined are infected with one or more species of enteric parasite, the prevalence of diarrhea is negligible (2%). The low prevalence of diarrhea in the presence of high parasite loads may be due to the practice of geophagy, which is engaged in by 76% of group members. Soil eaten by these monkeys contains large amounts of kaolinitic clays. Kaolin-based pharmaceuticals (i.e. Kaopectate) are commonly used in human populations to treat diarrhea and intestinal upsets. The mechanical and pharmaceutical properties of the natural kaolinite-based clays may counteract the effects of parasitosis in this free-ranging population.

Balantidiase / Balantidiasis

O autor faz uma revisao detalhada da balantidiase, abrangendo os aspectos epidemiologico, clinico diagnostico e tratamento e salienta a raridade da infeccao entre nos