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Invasive balantidiasis presented as chronic colitis and lung involvement.

A unique case of chronic balantidiasis is described, presenting with chronic colitis and inflammatory polyposis of the rectum and sigmoid colon and an intrapulmonary mass. Histology of the colonic polyps showed Balantidium coli, and both Aspergillus and Balantidium coli were found in the aspirate of the pulmonary mass. The patient was treated with doxycycline HCl 100 mg/day for 10 days with complete clinical recovery and marked improvement of the endoscopic appearance of the colonic mucosa.

Aged

Clinical trials with metronidazole in human balantidiasis.

Therapeutic activity of metronidazole against Balantidium coli was evaluated by using two drug regimens in 20 human cases of balantidiasis. All patients also harbored Trichuris trichiura. Children received a total amount of drug that varied from 2.5 g during 5 days to 7.5 g in a period of 10 days. Adults were given 5 g in 5 days or 12.5 g during a period of 10 days. In all patients B. coli disappeared after the 4th day of treatment. Frequent posttreatment stool examination remained negative. All patients tolerated the drug well and there were no side effects.

Adolescent

[A fatal case of intestinal balantidiasis].

A fatal case of a 63-year-old pig-raising country woman with an eight-day course of nausea, vomiting, dysentery with intestinal bleeding the latter being the direct cause of death. The autopsy showed ulcerative colitis due to B. coli, which was easily observed on histological examination of the large bowel.

Agricultural Workers' Diseases

[Balantidiasis].

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Animals

Human balantidiasis. A case report.

A 58-year-old woman, who presented to hospital with melaena and faecal peritonitis due to a perforated terminal ileum, was found to be infected with Balantidium coli. This protozoan parasite is commonly found in pigs, but can infect man, and may mimic amoebic infection. The diagnosis may be missed unless fresh stools are examined immediately. The patient died from septicaemia.

Balantidiasis

[Importance of cellular immunity factors in the pathogenesis of experimental balantidiasis].

Adult white rats were immunized by numerous subcutaneous injections of antigenes obtained from the cultures of B. coli and B. suis. After the rats were sensibilized they were infected with cultural forms of Balantidium. 75% of infected rats were found to have ciliates in the lumen of the large intestine. In the tissues of the intestinal wall up to the muscular layer there were observed certain pathomorphological changes such as hyperemy, oedema, haemorrhagia and ulcers. By means of the macrophaga migration test it was established that in rats during their immunization and following infection appear lymphocytes which are sensibilized in relation to the balantidial antigene that points to the formation of slow allergy in their organisms.

Animals

Massive development of amebas in the large intestine. Fedor Aleksandrovich Lesh (Lösch).

Fedor Aleksandrovich Lesh (Lösch) 1840-1903. Although Lösch was a distinguished Russian physician, little has been written about him in English. A graduate of the Medico-chirurgical Academy in St. Petersburg (1863), he defended a doctoral thesis on pulmonary embolism and infarction in 1866, and became an assistant professor of medicine in 1871. From 1872 to 1885 he was a lecturer on diagnosis at the Women's Medical College and a consultant to the Nikolayev Military Hospital. In 1885 he became Professor of Diagnostic Medicine at Kiev University where he remained until his retirement in 1897. In 1870, Lösch found Balantidium coli in the stools of two patients and made a detailed study of the clinical aspects of balantidiasis. In the same year he described in detail Giardia lamblia and Blastocystis hominis. Altogether, he published some 20 papers on the diagnostic and clinical aspects of various diseases, with special emphasis on the microscopic aspects of coprology. It was in 1875 (exactly 100 years ago) that Lösch, in this monumental paper, reported the clinical aspects of recurrent intestinal amebiasis, identified and described its cause, Entamoeba histolytica, and produced the disease in an experimental animal. This work on amebiasis was completed while he was assistant professor at St. Petersburg, on the wards of Prof. E. Eichwald. Clinicians will cherish the description of the patient's symptoms; protozoologists must be delighted by the description of the parasite and its motility; experimentalists will be nervous about his luck in infecting one of three dogs; and iconoclasts must derive satisfaction from Lösch's caution in not automatically assigning a direct causal relationship between the presence of the parasite and the disease.

Adult

Free radical metabolism of antiparasitic agents.

In recent years it has been apparent that many of the known antiparasitic drugs produce free radicals. Intracellular reduction followed by autooxidation yielding O.-2 and H2O2 has been suggested as the mode of action of nifurtimox on Trypanosoma cruzi and as the basis of its toxicity in mammals. On the other hand, free radical intermediates that do not generate oxygen-reduction products under physiological conditions have been found in the metabolic pathways of other antiparasitic nitro compounds (benznidazole, metronidazole, and other 5-nitroimidazoles) used in the treatment of diseases such as Chagas' disease, trichomoniasis, giardiasis, balantidiasis, amebiasis, and schistosomiasis. In these cases, as well as in the case of niridazole (used in the treatment of schistosomiasis), covalent binding or other interactions of the intermediates of nitroreduction with parasite macromolecules are possibly involved in their toxicity. Redox cycling of these compounds under aerobic conditions appears to be a detoxification reaction by inhibiting net reduction of the drugs.

Animals

A new guinea pig mutant with abnormal hair production and immunodeficiency.

Hairless guinea pigs were born in a closed colony of Hartley guinea pigs. At birth, hairless guinea pigs were smaller than littermates, had wrinkled skin and stunted vibrissae. The most striking abnormality histologically was distension of the upper portion of the pilary canal with thickening of the epidermis. Hairlessness resulted from production of abnormal hair shafts. Preliminary work indicated that in addition to hairlessness, the guinea pigs were athymic or hypothymic. Initial immunologic studies showed that the guinea pigs also were agammaglobulinemic. Animals that survived the weaning period died of infections that are usually associated with immunodeficiencies, such as systemic cytomegalovirus, systemic balantidiasis and Pneumocystis carinii pneumonia.

Animals

Colo-rectal biopsy in inflammatory bowel disease.

The term inflammatory bowel disease (IBD) is viewed as all-inclusive, covering the full panoply of intestinal disorders in which inflammatory changes are a prominent feature, including those of infectious, toxic, and intrinsic origin as well as the idiopathic entities ulcerative colitis and Crohn's disease. This chapter describes and discusses those aspects of colo-rectal biopsy in IBD which can help pathologists make optimal interpretations. The areas covered are: 1) methods used to prepare biopsy specimens for study, 2) normal histologic findings and common artefacts, 3) basic pathologic changes occurring in IBD, 4) a general approach to differential diagnosis in IBD, and 5) discussion of the various individual forms of IBD. The importance of full and reliable information exchange between the endoscopist and pathologist is stressed. Special attention is given to features in biopsy specimens which help in differentiating between ulcerative colitis and Crohn's disease. Other entities discussed are bacterial dysenteries; gonococcal proctitis; tuberculosis; Whipple's disease; amebiasis; balantidiasis; schistosomiasis; cryptosporidiosis; lymphopathia venereum; cytomegalovirus infection; histoplasmosis; antibiotic colitis; IBD due to cytotoxic drugs (5-FU), heavy metals, and foodstuffs; irradiation colitis; ischemic colitis; solitary ulcer syndrome; diverticulitis; and colitis secondary to obstruction. The term pseudomembranous enterocolitis is also considered.

Biopsy

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