Balantidium coli: Difference between revisions
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
*''Entamoeba histolytica'' | |||
*''Shigella'' | |||
*''Salmonella'' | |||
*''Campylobacter'' | |||
*''E.coli'' | |||
*IBD | |||
==Workup== | ==Workup== | ||
Revision as of 14:19, 16 August 2014
Background
- Infection of large intestine by parasite, Balantidium coli
- large, ciliated protozoan
- simple life cycle: dormant cyst to trophozoite to cyst
- Reservoir host is pig (asymptomatic)
- Pig sheds feces with cysts => contaminated water and food => ingested by humans => parasite resides in large intestine
- Parasite usually resides in lumen of intestine but can also penetrate mucosa
- Opportunistic infection
- Human-to-human transmission via fecal-oral route as well
- Worldwide prevalence 0.02-1% . Found wherever pigs are found
- Risk factors:
- Close contact between human and pigs
- Lack of appropriate waste disposal that can contaminate drinking water sources
- Subtropical/tropical climates (warmth and humidity favor survival of cyst)
- Compromised immune system, elderly, malnourished, alcoholics
Clinical Features
- Range of mild to severe disease
- Asymptomatic hosts (usually immunocompetent)
- Chronic infection: non-bloody diarrhea, cramping, abdominal pain
- Fulminant balantidiasis: mucoid, bloody stools
- Rarely, colonic perforation
- Extra-intestinal cases are rare
- Rarely infecting lungs causing pneumonia or pulmonary hemorrhage
- Mostly seen in elderly or immunocompromised
- Death is rare
Differential Diagnosis
- Entamoeba histolytica
- Shigella
- Salmonella
- Campylobacter
- E.coli
- IBD