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Ciliates
Protozoans parasite
Cilia
Hair-like cytoplasmic extensions
Balantidium coli
Largest protozoan parasite affecting humans and the only ciliate known to cause disease in humans.
Ovoid to sac-shaped
Shape of trophozoite
Balantidium
little bag
Neobalantidium coli or Balantioides coli
Other names
Paramecium coli
Identified as ____________ by Malmsten in 1857.
Balantidiasis , balantidiosis, or balantidial desentery
Its Zoonotic disease
Pigs
Normal host
Rotary, boring motility
Motility
Covered with cilia arranged in a longitudinal pattern extending from the oral to the caudal region
Locomotion (trophozoite)
Cytostome
Oral apparatus; acquire food
Cytopyge
Waste excretion
Macronucleus and Micronucleus
2 nuclei under trophozoite
osmoregulatory organelles
Function of the 2 vacuoles
Macronucleus
Bean-shaped or kidney bean shaped; can easily be identified in stained preparations; often appear as a hyaline mask especially in unstained preparations
Micronucleus
Small dot-like nucleus; round and lies in the concavity of the macronucleus; often not readily visible even in stained preparations
Cytoplasm
May contain food vacuoles and ingested microbes
Mucocysts
Extrusive organelles; located beneath the cell membrane; might have a function in the adhesion of the parasitic ciliates; may contribute to the parasite virulence (no definitive study to prove)
Cyst
Spherical or subspherical to slightly ovoid in shape
Cyst
Are covered with thick cell walls and they are referred to as “double walled cyst”
Mature cyst
This cyst tend to lose their cilia
Cyst
Only macronucleus is seen
Cyst
Infective stage
Trophozoite and cyst stage
Diagnostic stage
Ingestion of food and/or water contaminated with Balantidium coli cysts
Mode of transmission
4-5 days
Incubation period
Small intestine
Where excystation occurs
Asexual
asymmetric binary fission (transverse binary fission
conjugation
conjugation
Lumen
Where encystation occurs
Binary fission
A method of asexual reproduction in which a single parasite divides either longitudinally or transversely into 2 or more equal number of parasite
Transverse binary fission
Mode of replication for ciliates
Longitudinal binary fission
Mode of replication for flagellates
Rounded base with wide neck ulcers
Characteristic ulcer , caused by hyaluronidase
Hyaluronidase
Lytic enzyme secreted by the trophozoite
Intestinal perforation
Acute appendicitis
Complications of balantidiasis
Co-infection with other organisms
may also contribute to the severity of the Balantidium coli infection
Intrinsic host factors that contribute to host susceptibility and severity of B. coli infection
Nutritional status
Intestinal bacterial flora
Achlorhydria
Alcoholisms
Presence of chronic disease
Nutritional status
Poor nutrition can weaken the immune system
Can make the body more susceptible to infections
Intestinal bacterial flora
The balance of bacteria in the intestines can influence how easily B.coli can infect the host
An imbalance in the normal flora may make it easier for the parasite to thrive
Achlorhydria
Refers to a lack of stomach acid
Normally helps kill harmful microorganisms
Without sufficient stomach acid the body is now vulnerable to infections including B.coli
Alcoholisms
Can weaken the immune system
Also alters gut flora and may damage the gastrointestinal tract
Presence of chronic disease
Can impair immune function making it easier for infections like Balantidiasis to develop
Asymptomatic carriers
Fulminant Balantidiasis / Balantidial Desentery
Chronic Balantidiasis
Clinical Manifestations
Asymptomatic carriers
Do not present with diarrhea or dysentery
May serve as parasite reservoir in the community
Fulminant Balantidiasis / Balantidial Desentery
Diarrhea with bloody and mucoid stools, sometimes may be indistinguishable from amebic dysentery
Acute cases may have 6 to 15 episodes of diarrhea per day accompanied by abdominal pain, nausea, and vomiting
Often associated with immunocompromised and malnourished states
Chronic Balantidiasis
Diarrhea may alternate with constipation
May be accompanied by nonspecific symptoms such as abdominal pain or cramping, anemia, and cachexia
Direct Examination
Concentration techniques
Sigmoidoscopy
Laboratory Diagnosis
Bronchoalveolar washings
Diagnosis in cases of pulmonary infection
Lugol’s iodine
sometimes used for staining, but may obscure internal morphological features
Tetracycline
Metronidazole
TREATMENT
Iodoquinol
Doxycycline
Nitazoxanide
Other alternative treatments