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Balantidiosis, or stomata, is gastrointestinal parasitosis caused by Balantidium coli. It is a parasite that occurs in many mammals, including humans. In most cases, the disease has few or no symptoms. Diarrhea may vary in severity with periods of exacerbation and remission.
A few words about Balantidiosis
Balantidiosis is a zoonotic disease of the digestive tract caused by the Balantidium coli parasite. It is a pathogenic protozoan located in the digestive tract not only of humans, but also of domestic pig and ciliates. Infection usually occurs after eating contaminated food, during the slaughter of animals or through contact with an infected person (less frequently). Balantidiosis is characterized by catarrh of the large intestine. Diarrhea may vary in severity.
Epidemiology
Balantidium coli is a cosmopolitan parasite that affects many species of mammals, including humans. The source of the protozoan is fresh or dried faeces of small rodents, farm animals (pigs, cattle) and domestic animals (dogs, cats). In countries with a climate, the hot reservoir of the parasite are, among others monkeys. The invasive form is Balantidium coli cysts. Invasion occurs through the faecal-oral route, after consuming contaminated food or water. As passive carriers, flies contribute to the spread of balantidiosis.
Infestation with Balantidium coli can be observed all over the world, but the greatest amount occurs in people who travel to tropical regions. In our country, the incidence of this disease has not been thoroughly investigated.
The causes of Balantidiosis
It is an etiological factor orzęsek Balantidium coli (colonic stomata) – the largest protozoan parasite in humans. The trophozoite can reach 200 mikrom in length. Trophozoites are released from the cysts in the small intestine. The lesions are located in the mucosa of the large intestine.
The disease is infected by ingestion through the oral cavity. It is enough to swallow protozoan cysts together with food or water infected with them. In humans, cysts are considered the main source of infection and are excreted together with pig faeces. That is why the greatest number of infections is visible in rural areas in people who come into contact with pigs on a daily basis.
After the cyst enters the human body, it begins in the final section of the small intestine the process of exterminationwhich consists in the secretion of trophozoites from the cysts, which successively reproduce through transverse division. After multiplication – some trophozoites enter the intercellular spaces, while the rest undergo the process of conjugation. The process of balantidiosis development ends with the conversion of trophozoites into cysts, which are then excreted out of the faeces.
Balantidiosis – clinical symptoms
Most infections are asymptomatic or mildly symptomatic. In clinical cases, invasion is characterized by diarrhea of varying severity (periods of exacerbation and remission). There is blood and mucus in the loose stools. Bowel movements are often preceded by a painful urge to stool (tenesmus). During the exacerbation period, the following may occur:
- nausea,
- vomiting,
- paroxysmal abdominal pain,
- headaches,
- insomnia,
- lack of appetite
- weight loss.
Anemia develops later. The course of balantidiosis is similar to that of intestinal amoebiasis. There have also been reports of protozoan invasion in the genital and urinary tract.
Clinical forms of balantidiosis include:
- acute intestinal balandithiosis
- chronic intestinal balandithiosis
A visit to the doctor is necessary in people with symptoms of balandithiosis.
Balantidiosis diagnosis
In the period of exacerbation, in loose fresh feces, oval trophozoites are found, equipped with short cilia, thanks to which they move in a circular motion. During the mute period, diagnostics are difficult. Due to the cyclical nature of cyst excretion, multiple microscopic examination of the faeces is recommended. Staining the preparations with Lugol’s solution facilitates diagnosis. Finding trophozoites or Balantidium coli cysts in the stool confirms stomata. Due to their large size, cysts are sometimes confused with the eggs of nematodes and tapeworms.
Disease differentiation
Balantidiosis should be differentiated from:
- amoebiasis (amoebiasis),
- dysentery,
- other infectious diarrhea,
- ulcerative colitis (colitis ulcerosa),
- functional bowel disease.
Balantidiosis – methods of treatment
The drug of choice in balantidiosis is tetracycline given 4 times a day at a dose of 500 mg for 10 days. The therapeutic effect is also obtained after application metronidazole at a dose of 750 mg three times a day for 3 days. There are also other alternatives nitroimidazole derivatives (tinidazole, ornidazole, secnidazole). It is also effective dijodohydroxychinolina (iodoquinol) at a dose of 650 mg three times a day for 3 days and nitazoxanide and furazolid. Apart from causal treatment, it is necessary to supplement fluids and electrolytes in justified cases. During the recovery period, probiotics are recommended.
How to prevent balantidiosis?
1. Observance of the basic rules of personal hygiene and sanitary regime in breeding pigs and cattle.
2. Consume safe (pathogen-free) water and food.
3. Protection of water, food products and dishes against the access of flies – passive carriers of Balantidium coli cysts.
Prognosis
The prognosis is usually good.
Source: J. Cianciara, J. Juszczyk, Infectious and parasitic diseases; Czelej Publishing House