Current world status of Balantidium coli.

Balantidium coli is a cosmopolitan parasitic-opportunistic pathogen that can be found throughout the world. Pigs are its reservoir hosts, and humans become infected through direct or indirect contact with pigs. In rural areas and in some developing countries where pig and human fecal matter contaminates the water supply, there is a greater likelihood that balantidiosis may develop in humans. The infection may be subclinical in humans, as it mostly is in pigs, or may develop as a fulminant infection with bloody and mucus-containing diarrhea; this can lead to perforation of the colon. The disease responds to treatment with tetracycline or metronidazole. Balantidiosis is a disease that need never exist given access to clean water and a public health infrastructure that monitors the water supply and tracks infections. Its spread can be limited by sanitary measures and personal hygiene, but it is a disease that will be around as long as there are pigs. Immunocompromised individuals have developed balantidiosis without any direct contact with pigs, perhaps with rats or contaminated produce as a possible source of infection. For the clinician, balanatidiosis should be included in the differential diagnosis for persistent diarrhea in travelers to or from Southeast Asia, the Western Pacific islands, rural South America, or communities where close contact with domestic swine occurs. Warming of the earth's surface may provide a more favorable environment, even in the now-temperate areas of the world, for survival of trophic and cystic stages of Balantidium, and its prevalence may increase. Effective sanitation and uncontaminated water are the most useful weapons against infection. Fortunately, balantidiosis responds to antimicrobial therapy, and there have been no reports of resistance to the drugs of choice.

Caso fatal de balantidíase intestinal / A fatal case of intestinal balantidíasis

Caso fatal de balantidíase em mulher de 63 anos, criadora de porcos, da zona rural de Uberaba. A doença evoluiu em oito dias com disenteria, náuseae vômitos, culminando em óbito por enterorragia. A necrópsia constatou-se colite ulcerada causada por B. coli, facilmente identificado ao exame histológico do intestino grosso

[A fatal case of intestinal balantidiasis]. / Caso fatal de balantidíase intestinal.

A fatal case of a 63-year-old pig-raising country woman with an eight-day course of nausea, vomiting, dysentery with intestinal bleeding the latter being the direct cause of death. The autopsy showed ulcerative colitis due to B. coli, which was easily observed on histological examination of the large bowel.