Balantidium

-Jayan Bajracharya
-B.Sc.MLT 3rd year
-Roll no. 04
 Contents
1. Introduction

2. Reservoir,source and transmission of infeection

3. Geographical distribution

4. Morphology

5. Lifecylce

6. Pathogenesis

7. labdiagnosis
 Family Balantidiidae
The ciliate protozoa belonging to the family Balantidiidae
show the following characterstics:

1. They are provided with cilia during some developmental

stage of their life cycle.

2. They contain two morphologically distinct nuclei, the

large bean shaped macronucleus and the minute
micronuclues, and

3. They are exclusive parasites of vertebrate and

invertibrate hosts inhabiting theit digestive tract.
 Genus Balantidium
The members of these species are oval in shape.

They have a conspicuous cytosome, cilia over their body,

contractile vacuole, and two nuclei(a macronucleus and a
micronucleus).

They multiply sexually by conjugation and asexually by

binary fission.

Balantidium coli is the only species pathogenic to humans.

 Balantidium Coli
It was first discovered in the faeces of patients with acute
dysentery.

It is the largest protozoal parasite of humans.

It lives in large intestine of a humans, pigs, monkeys and

rodents.
Geographical distribution

The infection is found worldwide.

Most cases have been reported from south and central

America, China , Indonesia, Philipines, Pacific islands, which
are endemic for the parasite.

The highest prevalence of human infection, upto 20% have

been reported in districts of West Irian in Indonesia.

Infection tends to be more common among humans who

handled pigs.
Case report in Nepal -
2011
Freshly passed stool sample from an apparently healthy 19 year
old male student, with complaints of borborygmy, mild
abdominal discomfort and anorexia for 1 week was obtained in
clinical laboratory service, Department of Microbiology,
BPKIHS. The patient hailed from Inuruwa, Sunsari. His source
of drinking water was tube well. There was no history of travel or
contact with farm animals. Within 1 hour of collection of
specimen routine stool microscopy revealed plenty of spirally
motile trophozoites around 50 µm long and 35 µm broad. The
active spirally motile trophozoites were identified as B. coli.
Reservior, source and transmission of infection

Pigs are the main reservoir and source of infection for humans.

Infected faeces of humans and pigs are the sources of infections.

Human acquire infection by ingestion of cysts present in water

or food contaminated with the faecal materials either from human
or pig.

Person to person transmission frequently occurs in the people

with low personal hygiene and is commonly seen in institutions
such as mental asylum.
Morphology

B.coli has two stages: Trophozoit and cyst.

The trophozoite is actively motile and is the

invasive stage.

The cyst stage is found in chronic cases and

carriers.
1. Trophozoite

 Trophozoite is oval and tapers anteriorly, measuring 60 to 70

µm in length and 40 to 50 µm in breadth. The anterior end is
narrow and the posterior end broad.

 The anterior end has groove (peristome) leading to mouth

(cytosome) and a short funnel-shapped gullet (cytopharynx).

 The posterior end contains an excretory opening (cytopyge).

 The cell is covered all over with short delicate cilia.

The cilia that line mouth part are larger(adoral cilia).

The cytoplasm of the trophozoite contains two nuclei, two

contractile vacuoles and numerous food vacuoles.

One nucleus is large, kidney-shaped macronucleus and other is

small, round micronucleus lying in the concavity of
macronucleus.

The trophozoite is motile and propelled forward by constant

synchronous motion of the cilia.

The trophozoite is capable of ingesting bacteria, red blood cells

and fat droplets.
2. Cyst

 The cyst is spherical or oval and mesures 50 to 60 µm in

diameter.

 It is surrounded by a thick and transparent double-layered

wall.

 The macronucleus, micronucleus and vacuoles are also present

in the cyst.

 Cilia may be seen in younger cysts but are always absent in

mature cysts. And the cyst is resistant form and infective stage.
Life cycle
Life cycle is completed in a single host. Pig is a natural host and
man is an accidental host.

Man acquires infection by ingestion of cysts from water, food

and hands contaminated with infective faeces.

Following ingestion, the cyst probably excyst in the small

intestine but multiplication occurs in large intestine, caecum and
terminal ileum.
Each cyst excysts to produce single trophozoite, which may
remain either in the lumen or invade submucosa of the large
intestine.

The trophozoites multiply asexually by binary fission, each

producing two daughter trophozoites.

Binary fission takes place first by division of the micronuclues

followed by division of the macronuclues and the cytoplasm.

Successive divisions produce a large number of trophozoites.

Frequently, trophozoites also replicate sexually(syngamy) by
conjugation.

During the process of conjugation two trophozoites come in

contact with each other and exchange muclear material between
them, after which they detach.

The trophozoites after a period of growth and multiplication

encyst to cysts in the lower part of the intestine and are passed
out in the faeces.

The infected person may pass trophozoite or cyst in the faeces.

The trophozoite does not encyst outside the body and
disintegrates.

The cysts passed in the faeces may contaminate food and

water and thus it is transmitted to other humans or animals.
Pathogenesis

Infection is often confined to the lumen and is asymptomatic.

Clinical disease results when the trophozoites invade the

mucosa and sub mucosa of large intestine.

Invasion is facilated by : a) Mechanical action of ciliary

movement of the trophozoites , and b) hyaluronidase produce by
the parasite .

The organisms invade the mucosa and submucosa causing

ulcers known as Balantidium ulcers.
Balantidium ulcers unlike that of amoebic ulcersdo not invade
the muscular layer of the intestine.

Demonstration of B.coli traophozoites in the pus confirms the

diagnosis of balantidium ulcer.

Perforation is the main complication.

The parasite does not invade liver or any other extra-intestinal

organs and tissues.
Lab diagnosis

Specimen :Stool is the specimen of choice.

These include:

1. Stool microscopy , and

2. Stool culture
1. Stool microscopy

 Demonstrating B.coli trophozoites and cysts in the faeces

makes diagnosis by microscopy.

 Trophozoites are the best demonstrated in the fresh

specimens of diarrhoeic and dysenteric stools in acute cases.

 In the direct wet mount preparation, their rapid revolving

motility and cilia present around the funnel shaped mouth
identify them.

 The cyst are demonstrated in semi- formed and formed stool

in chronic cases.
2. Stool culture

 B.coli can be cultured in Robinson’s medium and other media

that are used for culture of Entamoeba histolytica.

3. Other tests

 Diagnosis can be made by demonstrating the trophozoites in :

a) Biopsy specimen of large intestine obtained by sigmoidoscopy
,and

b) Scrapings of ulcers.
THANK YOU