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Severe peritonitis due to Balantidium coli acquired in France.

The case reported here concerns an alcoholic pork-butcher who presented with severe colitis with peritonitis, caused by the only ciliate protozoan capable of infecting humans, Balantidium coli. This parasite is common in a variety of domestic and wild mammals, mainly pigs; however, its prevalence rate in humans is very low--particularly in industrialised, northern countries, including France. The infection is most frequently acquired by ingesting food or water contaminated by pig faeces, and it may be asymptomatic or may cause acute diarrhoea. Specific antibiotic treatment is efficacious, and it is important to consider the risk of this parasitic disease in susceptible patients presenting with bloody diarrhoea.

Animals↗

Prevalence of Cryptosporidium infections in pigs in Aragón (northeastern Spain).

Faecal samples from 620 pigs randomly selected from 27 farms throughout Aragón were examined to determine the prevalence of Cryptosporidium infections. Detection of oocysts was performed using the ethyl-acetate stool concentration method and the modified Ziehl-Neelsen technique. Cryptosporidium parvum oocysts were identified in 136 (21.9%) pigs from 21 (77.8%) farms. Infected animals ranged from 1 to 6 months old and oocysts were not detected in suckling piglets or adults. Infection rates were significantly higher in weaned, 1-2 month old piglets (59.2%) than in fattening, 2-6 month old pigs (34.3%) (P < 0.001). Cryptosporidial infections were asymptomatic in most of the pigs (90.4%) and usually of low intensity, since 92.6% of the infected pigs excreted few oocysts (0-1 oocysts per field at x 200 magnifications). Although 24.1% of weaned and 5.6% of fattening pigs infected by C. parvum had diarrhoea, it was not found to be statistically associated with infection. In fact, infection rates were higher in non-diarrhoeic than in diarrhoeic pigs, in both weaned (64.7% and 46.7%, respectively) and fattening pigs (34.3% and 33.3%).

Age Factors↗

Dysentery caused by Balantidium coli--report of two cases.

The authors present two cases of dysentery caused by Balantidium coli with numerous colonic ulcers, documented by colonoscopy and diagnosed by endoscopic biopsies. The positive rectal exudate in one case permitted the isolation and ultrastructural study of the trophozoites. The good response to tetracyclines in the younger patient was not repeated in the older patient, who died in septic shock despite antibiotic therapy. The authors report the endoscopic findings and comment on the differential endoscopic diagnosis between parasitic and other organic colitis in view of the rarity of these examples as isolated cases in Western countries.

Aged↗

Typhlitis due to Balantidium coli in captive lowland gorillas.

Typhlitis caused by Balantidium coli and requiring surgical resection occurred in three captive lowland gorillas over a 30-month period. Not one of the other gorillas in the colony or their keepers was ill. B. coli is distributed widely geographically and widely among mammals. Asymptomatic commensalism predominates, but invasion of the colonic mucosa can produce diarrhea and dysentery and set the stage for local or systemic spread.

Animals↗

Treatment of intestinal parasitic disease.

Although improved sanitation in the United States has resulted in a general diminution in the prevalence of intestinal parasitic infections, some, such as enterobiasis, are not reduced by improved environmental or water sanitation and others, such as amebiasis and hookworm infection, persist in foci. Other infections, notably giardiasis, have increased due to the travels of American tourists in other countries where environmental sanitation is poor. North American physicians, therefore, may expect at some time to have to treat parasitic infections. Favored chemotherapeutic agents currently are: for amebiasis--metronidazole and diiodohydroxyquin; for giardiasis--metronidazole; for tapeworm infections--niclosamide; for enterobiasis--pyrantel pamoate, piperazine citrate, or pyrvinium pamoate; for ascariasis--piperazine citrate; for stronglyoidiasis--thiabendazole; for trichuriasis--mebendazole; for hookworm infection--pyrantel pamoate; for schistosomiasis japonica--tartar emetic; and for schistosomiasis mansoni--niridazole.

Amebiasis↗

New species of Balantidium and Paracichlidotherus (Ciliophora) inhabiting the intestines of four surgeonfish species from the Tuvalu Islands, Pacific Ocean.

Four species of adult herbivorous surgeonfishes (Family Acanthuridae) were collected from the remote South-Pacific island system of Tuvalu. Their intestinal contents were examined, and of four populations of ciliated protists, two new species were discovered and are described. Ciliates were examined after protargol staining and, in some cases, scanning electron microscopy. Members of each population were examined and 10 characters measured for the balantidia, and 13 for the paracichlidotherids. A new Balantidium is described which has an unusually large dextr-oral field of cilia. A new species of Paracichlidotherus was discovered which has a macronucleus significantly smaller and well anteriad the cytoplasmic portion of the oral polykinetids relative to the type species.

Animals↗