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.

Paromomycin sulfate is an effective treatment for balantidiasis in captive cynomolgus monkeys.

There are few effective antimicrobial agents against Balantidium coli infection. The effect of paromomycin sulfate (PS) against B. coli was confirmed in this study of 596 captive cynomolgus monkeys. In several trials, the minimum dose and duration of oral administration of PS were 25 mg/day for 5 + 5 days, with a 2-day withdrawal interval. To facilitate daily PS administration, pumpkin cakes supplemented with PS were made, which not only resulted in precise effects but also increased the efficiency of preparation and administration of PS by the animal care staff. No cysts or trophozoites were detected at 14 or 16 days after the last treatments. There were no obvious differences in blood and biochemical parameters between before and after administration of PS. These results indicate that PS is effective for elimination of B. coli without hematological side effects. These data could contribute to the control of microbiological pathogens during veterinary care and colony management in primate facilities.

Rare Case of Polymicrobial Keratitis With Balantidium coli.

PURPOSE: To report a rare case of polymicrobial keratitis due to Balantidium coli and gram-negative bacteria, Pseudomonas aeruginosa and Klebsiella pneumoniae, in a soft contact lens (CL) wearer. METHODS: We report a case of CL-related keratitis due to B. coli, P. aeruginosa, and K. pneumoniae. RESULTS: The culture of the corneal scrapings, the CL cleaning solution, and the CL revealed the growth of a rare ciliated parasite, B. coli, along with gram-negative bacteria, namely, P. aeruginosa and K. pneumoniae. The patient was successfully treated with topical broad-spectrum antibiotics and intravenous metronidazole. CONCLUSIONS: Polymicrobial keratitis has seldom been reported with B. coli as the causative agent. CL wear can be a risk factor for this infection. Treatment with topical antibiotics may not suffice, and the intravenous route of antiprotozoal drugs may be a useful adjunct. Increasing awareness, early diagnosis, and treatment may improve the final visual outcome.

Prevalence, hematology, and treatment of balantidiasis among donkeys in and around Lahore, Pakistan.

The prevalence of Balantidium coli among donkeys in Lahore and adjoining areas was surveyed and a trial conducted to determine the efficacy of two antiprotozoal drugs: secnidazole (Dysen Forte) and Kalonji (Nigella sativa). Four-hundred donkeys were examined, and 73 (18.3%) were found positive for Balantidium coli. A slight decrease in PCV and an increase in Hb values of infected donkeys were found after antiprotozoal treatment. Secnidazole was 89.5% effective for the treatment of equine balantidiasis compared to 40.0% for Nigella sativa. This is the first report of balantidiasis in equines from Pakistan. It is not known if balantidiasis is an emerging problem in equines or whether it is a newly reported infection.

Prevalence and chemotherapy of Balantidium coli in cattle in the River Ravi region, Lahore (Pakistan).

The prevalence of Balantidium coli in cattle from the River Ravi region of Lahore was examined and the efficacy of three treatments measured. A total of 200 fecal samples were collected from cattle and examined microscopically; 50 (25%) were positive for B. coli cysts. The final efficacy of treatment with metronidazole, oxytetracycline, or secnidazole was 37.5%, 62.5%, and 87.5%, respectively, making secnidazole the most effective.

Amebae and ciliated protozoa as causal agents of waterborne zoonotic disease.

The roles free-living amebae and the parasitic protozoa Entamoeba histolytica and Balantidium coli play as agents of waterborne zoonotic diseases are examined. The free-living soil and water amebae Naegleria fowleri, Acanthamoeba spp., and Balamuthia mandrillaris are recognized etiologic agents of mostly fatal amebic encephalitides in humans and other animals, with immunocompromised and immunocompetent hosts among the victims. Acanthamoeba spp. are also agents of amebic keratitis. Infection is through the respiratory tract, breaks in the skin, or by uptake of water into the nostrils, with spread to the central nervous system. E. histolytica and B. coli are parasitic protozoa that cause amebic dysentery and balantidiasis, respectively. Both intestinal infections are spread via a fecal-oral route, with cysts as the infective stage. Although the amebic encephalitides can be acquired by contact with water, they are not, strictly speaking, waterborne diseases and are not transmitted to humans from animals. Non-human primates and swine are reservoirs for E. histolytica and B. coli, and the diseases they cause are acquired from cysts, usually in sewage-contaminated water. Amebic dysentery and balantidiasis are examples of zoonotic waterborne infections, though human-to-human transmission can occur. The epidemiology of the diseases is examined, as are diagnostic procedures, anti-microbial interventions, and the influence of globalization, climate change, and technological advances on their spread.

[A case of coinfection by Balantidium coli and HIV in French Guiana]. / Un cas de co-infection par Balantidium coli et VIH en Guyane Française.

A case of balantidial dysentery is reported in a patient infected with the HIV in French Guiana. This case is the first described in medical literature. The patient presented also a disseminated histoplasmosis. Immunosuppression probably favoured the evolution of asymptomatic carriage to clinical dysentery. This clinical case did not present any complications. Treatment with doxycycline had to be carried out for 20 days in order to obtain a clinical and parasitological cure.

Invasive balantidiasis presented as chronic colitis and lung involvement.

A unique case of chronic balantidiasis is described, presenting with chronic colitis and inflammatory polyposis of the rectum and sigmoid colon and an intrapulmonary mass. Histology of the colonic polyps showed Balantidium coli, and both Aspergillus and Balantidium coli were found in the aspirate of the pulmonary mass. The patient was treated with doxycycline HCl 100 mg/day for 10 days with complete clinical recovery and marked improvement of the endoscopic appearance of the colonic mucosa.

Balantidiasis humana en la isla de Chiloé, Chile / Human balantidiasis in the Chiloé Island, Southern Chile

Se comunica la experiencia lograda en balantidiasis humana con el hallazgo de 44 casos en el Hospital de Achao, Chiloé, durante el período de 1979-1986, mediante examen coproparasitológico seriado. Todas las personas infectadas provenían de localidades rurales, tenían contacto con cerdos y vivían en condiciones deplorables de saneamiento básico. 41 de los casos (93,2%) correspondieron a niños, siendo los preescolares el grupo más afectado (50%), al igual que el sexo masculino (61,4%). En el 97,7% de los casos había también otros parásitos en las deposiciones, principalmente Ascaris sp (86,4%), Trichuris sp (84,1%) y G. lamblia (22,3%). 14 casos fueron hospitalizados y en éllos se realizó estudio clínico. La gran mayoría de éstos casos (92,9%) correspondió a pacientes asintomáticos o con síntomas inespecíficos y hubo uno sólo con diarrea disentérica, incluyendo los 30 pacientes ambulatorios. Se obtuvo buena respuesta al tratamiento con diyodohidroxiquinoleína en niños y con tetraciclina en adultos. Dada la frecuencia con que se observa ésta infección en la zona, se propone adiestrar a los equipos de salud rural para educar a la población respecto a mejorar las condiciones de saneamiento básico y el adecuado manejo de la crianza de cerdos

Colitis pseudomembranosa y balantidiasis: informe de un caso / Pseudomembranous colitis and balantidiasis: a case report

Presentamos el caso de un paciente de sexo masculino de 52 años de edad, portador de una balantidiasis colónica a la que se asocia una colitis pseudomembranosa posiblemente por antibióticos. En la literatura médica revisada no encotramos publicaciones sobre dicha asociación

Epizootic of balantidiasis in lowland gorillas.

Acute enteritis characterized by watery diarrhea and lethargy occurred in 4 lowland gorillas (Gorilla gorilla gorilla) during a 5-week period at the Los Angeles Zoo. Numerous trophozoites of Balantidium coli were seen in fresh feces from each gorilla. Potentially pathogenic bacteria were isolated from 1 fecal sample. Results of fecal flotation examinations were negative for eggs of metazoan parasites. The gorillas were treated with antibiotics and metronidazole or paromomycin, or both. The most severely affected gorilla had blood and mucus in its feces, became dehydrated, and required hospitalization for supportive fluid therapy. This gorilla as well as the other gorillas recovered rapidly with treatment. Balantidium coli was not seen in fecal samples after the gorillas' recovery.