Balantidiasis: Diagnosis, Treatment, Prevention

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Balantidiasis

The content of the article:

1. Causes and risk factors
2. Forms of the disease
3. Symptoms
4. Diagnostics
5. Treatment
6. Possible complications and consequences
7. Forecast
8. Prevention

Balantidiasis is a zoonotic intestinal protozoal infection, characterized by severe intoxication and ulcerative lesions of the mucous membrane of the large intestine, with a tendency to protracted course.

Zoonotic infections are a group of diseases, the causative agents of which are parasitic in the body of certain species of animals, which are long-term hosts for pathogenic microorganisms.

The causative agent of balantidiasis is the infusorium of the genus Balantidium coli

The causative agent of the disease is the simplest, ciliate of the genus Balantidium coli. Despite the fact that the microorganism was described for the first time back in 1857, its ability to cause disease in humans was proved only in 1901 by N. S. Soloviev. Among the infectious agents that provoke intestinal diseases, balantidia is the largest: the vegetative form is 50–80 µm in length, 35–60 µm in width, the diameter of the cyst (temporary form covered with a protective membrane) is about 50 µm.

The owner of balantidia is pigs (usually young pigs), for which microorganisms are not dangerous. The route of infection is fecal-oral, infection is possible through direct contact. The disease is usually recorded in regions with a developed pig-breeding industry, more often in the rural population or pig-breeding workers.

Despite the fairly frequent infection with balantidia (4-5%), a detailed clinical picture is observed in isolated cases.

Infection with vegetative forms of the simplest is virtually impossible, since they are not viable in the environment, and occurs due to cysts that can persist for up to 100 days in pig farms and more than 200 days in the soil. For this reason, a sick person (as well as an asymptomatic carrier of balantidia) practically cannot serve as a source of infection, since cysts are not formed in the human body, and if they occur, then in extremely small quantities.

Causes and risk factors

The main cause of the disease is the ingress of cysts (in exceptional cases, vegetative forms) into the human gastrointestinal tract through the use of water or crops contaminated with cysts.

Infection with balantidiasis occurs due to the use of cyst-contaminated water or crops

For unknown reasons, in most cases, the microorganism exists for a long time in the intestine in the form of a cyst, without causing disease. Excistation occurs only in a small part of the infected (exit from the ciliate cyst, covered with longitudinal rows of cilia, with the help of which movement is carried out). Under the influence of a proteolytic enzyme (hyaluronidase) secreted by balantidium, the ciliate is introduced into the intestinal wall. In the intestinal wall, the parasite actively multiplies, which is accompanied by necrosis of the mucous membrane. When the bacterial flora joins, a pronounced inflammatory reaction develops around the foci of necrosis.

Risk factors:

• use of non-disinfected water from open reservoirs;
• eating vegetables without pretreatment;
• neglect of personal hygiene measures after contact with pigs (in the household, on pig farms).

Forms of the disease

According to the duration of the course, acute and chronic balantidiasis are distinguished.

Depending on the severity, there are such forms of the disease:

• easy;
• medium-heavy;
• heavy.

The latent form implies the carriage of pathogenic microorganisms in the absence of clinical manifestations.

The combined form of balantidiasis is said to be when the underlying disease is combined with other infections (for example, amebiasis or shigellosis).

Symptoms

For the acute form of the disease, characteristic violent, detailed symptoms.

After infection with balantidia, the symptoms of the disease are absent for 5-30 days (latent incubation period).

Getting into the gastrointestinal tract, the microorganism affects the intestinal wall, causing at the initial stage edema and hyperemia of the mucous membrane, which are replaced as the process progresses with hemorrhages and foci of necrosis, accompanied by powerful intoxication, which manifests itself:

• weakness, deterioration in general health;
• headache, dizziness;
• decreased or complete lack of appetite;
• an increase in body temperature to 38.5–39 ° С;
• cramping abdominal pain;
• frequent false urge to defecate;
• liquid fetid stools mixed with blood, pus, mucus (10-15 times a day).

Objective signs: the tongue is dry, coated with a white coating, the liver and spleen are enlarged, the abdomen is sharply painful when pressed in the umbilical region and in the lower sections.

With balantidiasis, the stomach hurts, the temperature rises, weakness and lack of appetite are observed

There is a rapid loss of body weight, depletion develops within a few days (up to a week).

In chronic balantidiasis, periods of exacerbation, which last from several days to a month, are replaced by imaginary well-being, vivid symptoms of the disease disappear for several months (on average, from 3 months to six months). The manifestations of the disease in this case are poorly expressed: minor abdominal pain, diarrhea 2-5 times a day (sometimes mixed with mucus, less often with blood), there are no manifestations of intoxication.

Diagnostics

When diagnosing balantidiasis, it is necessary to take into account the presence of an unfavorable epidemiological history.

Laboratory and instrumental diagnostic methods:

• microscopy of a smear of liquid feces (no later than 40 minutes after a bowel movement);
• microscopy of a biopsy specimen of the large intestine obtained during endoscopic examination;
• endoscopic examination of the interested parts of the intestine (sigmoidoscopy).

Treatment

Patients with an acute form of the disease are subject to compulsory hospitalization in an infectious diseases hospital.

With balantidiasis, antimicrobial therapy is performed

Treatment of the disease is carried out in several directions:

• etiotropic therapy aimed at destroying the pathogen (antimicrobial agents);
• symptomatic drugs (hemostatics, reparants, antispasmodics, enzyme preparations);
• immunostimulating therapy;
• emergency surgery (if necessary).

Possible complications and consequences

Complications of the disease are associated with perforation and ulceration of the intestinal wall or a large vessel. It:

• perforation of the intestinal wall;
• diffuse peritonitis;
• intestinal bleeding.

If left untreated, balantidiasis may develop gastrointestinal bleeding.

Forecast

With timely treatment, the prognosis is favorable. In the absence of medical care, the process becomes chronic, the mortality rate reaches 10% or more.

Prevention

There are currently no specific preventive measures for balantidiasis. The following are non-specific:

• compliance with the rules of personal hygiene;
• organization of a system for protecting water bodies from fecal contamination by sewage;
• compliance with protective measures in pig farms in order to prevent soil contamination;
• timely identification of infected persons, implementation of special control over risk groups (systematic preventive examinations).

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Olesya Smolnyakova Therapy, clinical pharmacology and pharmacotherapy About the author

Education: higher, 2004 (GOU VPO "Kursk State Medical University"), specialty "General Medicine", qualification "Doctor". 2008-2012 - Postgraduate student of the Department of Clinical Pharmacology, KSMU, Candidate of Medical Sciences (2013, specialty "Pharmacology, Clinical Pharmacology"). 2014-2015 - professional retraining, specialty "Management in education", FSBEI HPE "KSU".

The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!