Balantidiasis Clinical Presentation

  • Author: Valda M Chijide, MD; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Nov 22, 2011
 

History

Potential symptoms of balantidiasis include the following:

  • Diarrhea (watery, bloody, mucoid)
  • Nausea
  • Vomiting
  • Abdominal pain
  • Anorexia
  • Weight loss
  • Headache
  • Mild colitis
  • Fever
  • Severe and marked fluid loss (resembling amebic dysentery)
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Physical

Patients with balantidiasis may present with abdominal tenderness, fever, and prolonged diarrhea, which may result in signs of dehydration.

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Causes

Risk factors for balantidiasis include contact with pigs, handling fertilizer contaminated with pig excrement, and living in areas where the water supply may be contaminated by the excrement of infected animals. Poor nutrition, achlorhydria, alcoholism, and immunosuppression may also be contributing factors.

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Contributor Information and Disclosures
Author

Valda M Chijide, MD  Clinical Professor, Department of Medicine, University of Saskatchewan; Consultant in Infectious Diseases, Regina, Saskatchewan, Canada

Valda M Chijide, MD is a member of the following medical societies: American College of Physicians, HIV Medicine Association of America, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Jeffrey D Band, MD  Professor of Medicine, Oakland University William Beaumont School of Medicine; Director, Division of Infectious Diseases and International Medicine, Corporate Epidemiologist, William Beaumont Hospital; Clinical Professor of Medicine, Wayne State University School of Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Ronald A Greenfield, MD  Professor, Department of Internal Medicine, University of Oklahoma College of Medicine

Ronald A Greenfield, MD is a member of the following medical societies: American College of Physicians, American Federation for Medical Research, American Society for Microbiology, Central Society for Clinical Research, Infectious Diseases Society of America, Medical Mycology Society of the Americas, Phi Beta Kappa, Southern Society for Clinical Investigation, and Southwestern Association of Clinical Microbiology

Disclosure: Pfizer Honoraria Speaking and teaching; Gilead Honoraria Speaking and teaching; Ortho McNeil Honoraria Speaking and teaching; Abbott Honoraria Speaking and teaching; Astellas Honoraria Speaking and teaching; Cubist Honoraria Speaking and teaching; Forest Pharmaceuticals Speaking and teaching

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

References

  1. Walzer PD, Judson FN, Murphy KB, et al. Balantidiasis outbreak in Truk. Am J Trop Med Hyg. Jan 1973;22(1):33-41. [Medline].

  2. Ferry T, Bouhour D, De Monbrison F, et al. Severe peritonitis due to Balantidium coli acquired in France. Eur J Clin Microbiol Infect Dis. May 2004;23(5):393-5. [Medline].

  3. Vasilakopoulou A, Dimarongona K, Samakovli A, et al. Balantidium coli pneumonia in an immunocompromised patient. Scand J Infect Dis. 2003;35(2):144-6. [Medline].

  4. Dodd LG. Balantidium coli infestation as a cause of acute appendicitis. J Infect Dis. Jun 1991;163(6):1392. [Medline].

  5. Anargyrou K, Petrikkos GL, Suller MT, et al. Pulmonary Balantidium coli infection in a leukemic patient. Am J Hematol. Jul 2003;73(3):180-3. [Medline].

  6. Arean VM, Koppisch E. Balantidiasis; a review and report of cases. Am J Pathol. Nov-Dec 1956;32(6):1089-115. [Medline].

  7. Aucott JN, Ravdin JI. Amebiasis and "nonpathogenic" intestinal protozoa. Infect Dis Clin North Am. Sep 1993;7(3):467-85. [Medline].

  8. Canadian Pharmacists Association. Compendium of Pharmaceuticals and Specialties (CPS). 2006;2182-2183.

  9. Esteban JG, Aguirre C, Angles R, et al. Balantidiasis in Aymara children from the northern Bolivian Altiplano. Am J Trop Med Hyg. Dec 1998;59(6):922-7. [Medline].

  10. Fisk T, Keystone J, Kozarsky P. Cyclospora cayetanensis, Isospora belli, Sarcocystis Species, Balantidium coli, and Blastocystis hominis. In: Mandell GL, Bennet JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 2. 6th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2005:3228-37.

  11. Garcia L, Bruckner D. Intestinal Protozoa: Flagellates and Ciliates. In: Diagnostic Medical Parasitology. 3rd ed. Washington, DC: ASM Press; 1997:34-53.

  12. Markell E. Lumen-Dwelling Protozoa. In: Markell and Voge's Medical Parasitology. 8th ed. Philadelphia, Pa: WB Saunders Co; 1999:24-89.

  13. Micromedex. Tetracycline. Drugdex Drug Evaluations. micromedex. Available at http://www.micromedex.com. Accessed 2000.

  14. Neafie R. Balantidiasis. In: Pathology of Tropical and Extraordinary Diseases. Vol 1. Washington, DC: Armed Forces Institute of Pathology; 1976:325-7.

  15. PDR. Physicians' Desk Reference. Montvale, NJ: Medical Economics Company, Inc; 2000.

  16. Rosenblatt JE. Antiparasitic agents. Mayo Clin Proc. Nov 1999;74(11):1161-75. [Medline].

  17. The Medical letter on drugs and therapeutics. Drugs for parasitic infections. Med Lett Drugs Ther. Jan 2 1998;40(1017):1-12. [Medline].

  18. Yazar S, Altuntas F, Sahin I, et al. Dysentery caused by Balantidium coli in a patient with non-Hodgkin's lymphoma from Turkey. World J Gastroenterol. Feb 1 2004;10(3):458-9. [Medline].

  19. Young MD. Attempts to transmit human Balantidium coli. Am J Trop Med Hyg. Jan 1950;30(1):71. [Medline].

 
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Trophozoite of Balantidium coli in colon. This photograph shows the large macronucleus and the thin cell membrane covered with cilia (X820). Courtesy of Armed Forces Institute of Pathology (AFIP 75-9300).
Cyst of Balantidium coli in feces. This photograph demonstrates a thick cyst wall and a large macronucleus (X820). Courtesy Armed Forces Institute of Pathology (AFIP 75-9301).
 
 
 
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