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Balantidiasis

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Synonyms of Balantidiasis

Disorder Subdivisions

General Discussion

Balantidiasis is a rare intestinal infection caused by the bacterium, Balantidium coli, a single celled parasite (ciliate protozoan) that frequently infects pigs but on occasion (rarely) infects humans. Some infected people may have no symptoms or only mild diarrhea and abdominal discomfort but others may experience more severe symptoms reminiscent of an acute inflammation of the intestines. Symptoms of Balantidiasis may be similar to those of other infections that cause intestinal inflammation, for example, amoebic dysentery.

Symptoms

Most people with Balantidiasis are asymptomatic or present mild symptoms. Some individuals may become acutely ill with abnormally high temperatures, nausea, vomiting, abdominal pain, and bloody diarrhea. Such conditions may result in the excessive loss of water from the body (dehydration) and extreme exhaustion (prostration), especially if B. coli attacks the intestinal lining causing inflammation and possibly "crater-like" areas of damage (ulceration). In very severe cases, the ulcers may be deep enough to puncture the intestinal wall (perforation) resulting in acute inflammation of the peritoneum, the membrane that lines the abdomen (peritonitis). Occasionally, the ulcer may diminish lung function.

Causes

Balantidiasis is a rare infectious disease caused by the single celled (protozoan) parasite Balantidium coli. This parasite may be passed directly to humans by contact with pig feces or indirectly by drinking contaminated water. Poor nutrition, a compromised immune system, or other illnesses may make a person vulnerable to more severe symptoms of this disease.

Affected Populations

Balantidiasis is a rare infection that affects males and females in equal numbers. It typically occurs in tropical regions such as Brazil, New Guinea, and southern Iran.

Related Disorders

Symptoms of the following disorders can be similar to those of Balantidiasis. Comparisons may be useful for a differential diagnosis:

Ulcerative Colitis is an acute inflammatory bowel disease characterized by diarrhea and blood in the stools because of multiple, irregular ulcerations of the bowel. The initial symptoms of this disorder may include a general feeling of weakness (malaise) and fatigue. There may be abdominal discomfort, along with a change in the frequency and consistency of stools. Other symptoms may include abdominal pain, cramping, and the urgent need to have a bowel movement (tenesmus). Weight loss and a decrease in appetite are also associated with Ulcerative Colitis. (For more information on this disorder, choose "Ulcerative Colitis" as your search term in the Rare Disease Database.)

Crohn's Disease is an inflammatory bowel disease characterized by severe, chronic inflammation of the intestinal wall or any portion of the gastrointestinal tract. Symptoms of this disorder include nausea, vomiting, fever, night sweats, loss of appetite, a general feeling of weakness, waves of abdominal pain and discomfort, diarrhea and rectal bleeding. (For more information on this disorder, choose "Crohn's" as your search term in the Rare Disease Database.)

Irritable Bowel Syndrome, also known as Spastic Colon, is a common digestive disorder that involves both the small intestine and the large bowel. This disorder is characterized by abdominal pain, constipation, bloating, nausea, headache, and/or diarrhea. The spastic colon type of this syndrome is characterized by variable bowel movements and abdominal pain that is associated with periodic constipation or diarrhea. Those patients with Irritable Bowel Syndrome who have painless diarrhea may experience an urgent need to defecate upon arising. (For more information on this disorder, choose "Irritable Bowel Syndrome" as your search term in the Rare Disease Database.)

Chronic Erosive Gastritis is an inflammatory disorder characterized by multiple lesions in the mucosal lining of the stomach. Symptoms of this disorder may include a burning or heavy feeling in the stomach, mild nausea, vomiting, loss of appetite and general weakness. In severe cases of Chronic Erosive Gastritis there may be bleeding from the stomach that can result in anemia. (For more information on this disorder, choose "Chronic Erosive Gastritis" as your search term in the Rare Disease Database.)

Other infectious diseases have symptoms that are similar to those of Balantidiasis including amoebic dysentery, shigella dysentery, Yersinia enterocolitica infection, amebiasis, chronic fungal bowel infections, intestinal tuberculosis, and pseudomembranous colitis that is caused by excessive use of antibiotics. Ischemic Colitis and certain cancers such as abdominal lymphoma may also cause symptoms that are similar to those of Balantidiasis.

Standard Therapies

Balantidiasis can be diagnosed by laboratory testing of the stool. Immature B. coli parasites (trophozoites) are usually recoverable from the stool. A more complex and more invasive diagnostic method involves scraping the ulcer and examining the tissue for trophozoites.

The antibiotic drug most frequently used to treat Balantidiasis is tetracycline. When tetracycline cannot be given (i.e., allergy), replacement drug therapy may include the drugs iodoquinol or metronidazole. It is not necessary to isolate (quarantine) a person who has Balantidiasis. However, the feces of infected individuals must be disposed of so that they do not come into contact with drinking water or food supplies.

Investigational Therapies

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.

For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:

Tollfree: (800) 411-1222
TTY: (866) 411-1010
Email: prpl@cc.nih.gov

For information about clinical trials sponsored by private sources contact:
www.centerwatch.com

Organizations related to Balantidiasis

References

TEXTBOOKS
Thoene JG., ed. Physicians' Guide to Rare Diseases. Montvale, NJ: Dowden Publishing Company Inc; 1995:528.

Fauci AS, et al., eds. Harrison's Principles of Internal Medicine, 14th Ed. New York, NY: McGraw-Hill, Inc; 1998:1204.

Sleisenger MH, et. al., Gastrointestinal Disease. 4th ed. Philadelphia, PA: W. B. Saunders Co; 1989:1171-72.

REVIEW ARTICLES
Garcia LS., Flagellates and ciliates. Clin Lab Med. 1999;19:621-38.

Juckett G., Intestinal protozoa. Am Fam Physician. 1996;53:2507-18.

JOURNAL ARTICLES
Lucas SD., Invasive balantidiasis presented as chronic colitis and lung involvement. Dig Dis Sci. 1989;34:1621-23.

Currie AR., Human balantidiasis. A case report. S Afr J Surg. 1990;28:23-25.

Report last updated: 2009/05/11 00:00:00 GMT+0