Balatidium coli

I-Taxonomic Classification:
Domain: Eukaryota
Phylum Ciliophora
Class: Litostomatea
Order Vestibuliferida
Family: Balantiididae
Genus: Balantidium
Species: Balantidium coli
II-Morphology:
For the morphological features of both trophozoite and cyst of the pathogenic ciliate).
III-Life Cycle:
*diagram is in the next uploaded item…
* summary:
B.coli infection results from ingestion of food and water contaminated with fecal matter
containing its cysts.Incubation period is normally 4-5 days -> ingested cysts excyst in the small
intestine and become trophozoites -> trophozoites inhabit the lumen,mucosa and submucosa
of the large intestine primarily the cecal region -> trophozoites multiply by binary fission and
cause pathologic changes in the colonic wall and mucosa -> trophozoites then encyst during
intestinal transport or after evacuation of semi-formed stools -> cysts(infective stage) go out
with fecal matter;cysts are viable for several weeks.

IV-Pathogenesis and Clinical Manifestations:

B.coli is a tissue invader.Its trophozoites are capable of attacking the intestinal epithelium
and creating characteristic ulcers with a rounded base and wide neck in contrast to the flask-
shaped slender necked ulcers of amoebiasis.Ulceration is caused by the lytic enzyme
hyaluronidase which is secreted by the trophozoite.The trophozoites are abundant in exudates
on mucosal surfaces while imflammatory cells and trophozoites are numerous in the base of
the ulcers.Trophozoites also invade the submucosa and the muscular coat ,including blood
vessels and lymphatics.They may spread to the mesenteric nodes ,the pleura or the liver.
 Many infected individuals are asymptomatic.Majority of symptomatic patients complain of
diarrhea and dysentery
.During acute infections,the patients usually complain of abdominal discomfort or pain
associated with nausea and vomiting.Balantidial dysentery is indistinguishable from amoebic
dysentery .The most common complaint is diRRHEA WITH BLOODY STOOLS.Acute cases may
have 6-15 episodes of diarrhea per day.In chronic disease,diarrhea may alternate with
constipation,and may be accompanied by anemia and cachexia.Chronic disease is also
associated with non-specific abdominal symptoms.Fulminant diseases occur in
immunocomromised or malnourished patients.Complications of Balantidiasis include intestinal
perforation and acute appendicitis.

V-Diagnosis:
Diagnosis is made by microscopic demonstration of trophozoites and cysts in feces using
direct examination or concentration techniques.Sometimes,repeated stool exams are done to
increase the sensitivity.Presence of trophozoites in biopsy specimens from lesions obtain
through sigmoidoscopy is likewise diagnostic.

VI-Treatment: any of the following…

1.500 mg Tetracycline,4x daily for 10 days(adults and older children) ;contradicted in children
less than 8 yrs.old & in pregnant women
2.750 mg Metronidazole 3x daily, for 5 days;pediatric dose is 35-50 mg/kg/day in 3 divided
doses for 5 days;contradicted in early pregnancy
3.650 mg Iodoquinol,3x daily for 20 days; pediatric dose is 40mg/kg/day in 3 divided doses for
20 days
Vii-Prevention and Control:
1.proper sanitation
2.safe water supply
3.protection of food from contamination
4.boiling of for drinkingwater
5.subjecting drinking water to 1% sodium hypochloride(ordinary chlorination of water is
ineffective)
References:Phil.Textbook of Medical Parasitology by belizario and de Leon;internet