Ciliates: Balantidium coli

(Ciliates) (CILIA) (Balantidium coli)

(_____)

• protozoan parasite

• hair-like cytoplasmic extensions- (____)

• one human pathogen- (________)

(Balantidium coli) (Balantidium) (Neobalantidium coli)

(Balantioides coli) (Paramecium coli) ( balantidiasis, balantidiosis, or

balantidial dysentery.) (pigs)

(_____________)

• trophozoite resembles a sac in shape. (__________) = “little bag”

• (____________) or (_____________)

• Initially identified as (__________) by Malmsten in 1857.

• Largest protozoan parasite affecting humans and the only ciliate known to cause disease in

humans. It is the causative agent of the zoonotic disease called (______, _________, _________)

• This organism is primarily associated with (____), its normal host.

(Balantidium coli, trophozoite) (LOCOMOTION) (Rotary, Boring motility) (Cytostome) (Cytopyge) (Macronucleus) (Micronucleus) (Contractile Vacuoles) (Mucocysts)

(_____________________)

• measures 30-150 μm long and 25-120 μm wide; ovoid to sac-shaped and is tapered at the

anterior end

• trophozoites are covered with cilia arranged in a longitudinal pattern extending from the oral to

the caudal region- for (____________)

• Motility: (_____________)

• (_______)- oral apparatus; acquire food

• (________)- waste excretion

• 2 nuclei: (__________)- bean-shaped, and (__________)- small dot-like nucleus

• (___________)- osmoregulatory organelles

• Cytoplasm may contain food vacuoles and ingested microbes

• (___________)- extrusive organelles

(Balantidium coli, cyst) (spherical or subspherical) ( double- walled) (Mature cysts)

(_____________)

• (_____________) to slightly ovoid in shape; measure 40-60 μm in diameter

• (___________); row of cilia may be visible between the two cyst wall layers

• (___________) tend to lose their cilia

(Cyst) (Trophozoites and Cyst) (Excystation ) (large intestine) (asymmetric binary fission) (encystation) (Mature cysts) () () () () () ()

Balantidium coli, cyst

Life cycle

• Infective stage: (_____)

• Diagnostic stage: (_____&_____)

• MOT: Ingestion of food and/or water

contaminated with Balantidium coli, cysts

• (___________) occurs in the small intestine

Trophozoites

o colonize the (___________)

o replicate by (___________)

o undergo (_________) to produce

infective cysts

o (__________) are passed with feces

(Rounded base with wide neck ulcers) (Hyaluronidase) (Nutritional status) (Intestinal bacteria flora) (Achlorhydria) (Alcoholism) (chronic disease)

Pathogenesis and Clinical Manifestations

• Characteristic ulcer: (________________)

• (__________)- lytic enzyme secreted by the trophozoite

Intrinsic host factors that contribute to host susceptibility and severity of Balantidium coli

infection:

• (__________)

• (____________)

• (_________)

• (__________), and

• Presence of (____________)

(Asymptomatic carriers) (Fulminant balantidiasis/ Balantidial dysentery) (6 to 15) (Chronic balantidiasis) () () () () () () ()

Balantidiasis has three forms of clinical manifestations:

• (_________________)

o do not present with diarrhea or dysentery

o may serve as parasite reservoir in the community

• (_________________________________)

o diarrhea with bloody and mucoid stools

o Acute cases may have (__-__) episodes of diarrhea per day accompanied by abdominal

pain, nausea, and vomiting

o often associated with immunocompromised and malnourished states

• (________________)

o diarrhea may alternate with constipation

o may be accompanied by nonspecific symptoms such as abdominal pain or cramping, anemia, and cachexia.

(mesenteric nodes, appendix, liver, genitourinary sites, pleura, and lungs) (intestinal perforation) ( acute appendicitis) () () () () ()

B. coli can spread to extraintestinal sites including the (____, ____, ____, ____, ____, ____, ____).

Complications of balantidiasis include (___________) and (___________).

Cases of mortality related to balantidiasis were reported to be associated with intestinal hemorrhage and

shock, intestinal perforation, or sepsis.

(direct examination or concentration techniques.) (sigmoidoscopy) (Bronchoalveolar washings) (Lugol’s iodine) () () () ()

Laboratory Diagnosis

• Microscopic demonstration of trophozoites and cysts in feces using (_________/_________)

• Demonstration of trophozoites in biopsy specimens from lesions obtained through

(_____________).

• (___________) in cases of pulmonary infection.

• (__________) is sometimes used for staining, but may obscure internal morphological features.

(Tetracycline or Metronidazole) (Tetracycline) (Adults and older children) (Metronidazole) (5 ) (Iodoquinol) (Doxycycline) (Nitazoxanide) () () () () () () ()

Treatment of choice: (________/__________)

• (___________)

o (______________): 500 mg or 40 mg/kg/dose divided in four doses for 10 days.

o contraindicated in children less than eight years of age and in pregnant women.

• (____________)

o 750 mg three times daily, or 35 to 50 mg/kg body weight/ day in three divided doses, may

be given for (__) days.

Other alternative treatments:

• (___________) may also be given at 650 mg, or 40 mg/kg/dose, divided in three doses for 20 days.

• (___________)

• (___________)

Currently there are no reports of B. coli exhibiting drug resistance.

(cosmopolitan) (poor sanitation) (pigs or pig feces) (overcrowded) (sanitation) (Safe water supply) (personal hygiene)

Epidemiology

• (__________) distribution

• more prevalent in areas with:

o (___________)

o close contact with (___________)

o (__________) institutions

Prevention and Control

• Proper (___________)

• (____________)

• Good (___________)

• Latin America, Middle East, Philippines, Papua New Guinea, and the West Irian province of Indonesia.

(Proper sanitation) (Safe water supply) (Good personal hygiene) (contamination ) (water sources & food crops ) (pig feces) (heat and by 1% sodium hypochlorite) () () () () () ()

Prevention and Control

• (___________)

• (_____________)

• (___________)

• Protection of food from (___________)

• Measures to limit contact of pigs with (_________&__________)

• Use of (_______) as fertilizer should also be avoided

Note: Cysts are easily inactivated by (_________&_________). Ordinary chlorination of water

is not effective against B. coli cysts.