Balanitidiasis

Infectious diseases

Clinicals - History

Fact Explanation
History of contact with pigs Balantidiasis (or balantidiosis) is a large-intestinal infection caused by Balantidium coli. Pigs are the primary reservoir. History of contact with pigs
Balantidiasis (or balantidiosis) is a large-intestinal infection caused by Balantidium coli. Pigs are the primary reservoir.
Asymptomatic Most of the infected patients do not manifest symptoms. These people can act as reservoirs and may transmit the disease to others. Asymptomatic
Most of the infected patients do not manifest symptoms. These people can act as reservoirs and may transmit the disease to others.
Diarrhea Diarrhea can be watery, bloody, or mucoid. Diarrhea is often explosive and frequent. Chronic diarrhea results due to chronic infection. Diarrhea
Diarrhea can be watery, bloody, or mucoid. Diarrhea is often explosive and frequent. Chronic diarrhea results due to chronic infection.
Abdominal pain Due to trophozoite invasion of the large bowel. Often patients complain of cramping abdominal pain. Some patients complain of associated anorexia , nausea and vomiting. Abdominal pain
Due to trophozoite invasion of the large bowel. Often patients complain of cramping abdominal pain. Some patients complain of associated anorexia , nausea and vomiting.
Fever A non-specific finding seen in some patients. Fever
A non-specific finding seen in some patients.
Tenesmus This is an unproductive urge to defecate. Tenesmus
This is an unproductive urge to defecate.
Symptoms of dehydration Severe and frequent diarrhea can result in significant fluid loss and dehydration. Patients present with increased thirst, reduced urine output, postural dizziness, weakness and fatigue. Symptoms of dehydration
Severe and frequent diarrhea can result in significant fluid loss and dehydration. Patients present with increased thirst, reduced urine output, postural dizziness, weakness and fatigue.
Headache Some patients have headache. Headache
Some patients have headache.
Weight loss Occurs secondary to chronic diarrhea. Weight loss
Occurs secondary to chronic diarrhea.

Clinicals - Examination

Fact Explanation
Fever Patients can have a febrile reaction due to the parasitemia. Fever
Patients can have a febrile reaction due to the parasitemia.
Abdominal tenderness Tenderness is poorly localized. Sometimes tenderness in the McBurney’s point is noted if appendicitis is associated with Balantidiasis. Abdominal tenderness
Tenderness is poorly localized. Sometimes tenderness in the McBurney’s point is noted if appendicitis is associated with Balantidiasis.
Signs of dehydration Patients present with increased thirst, reduced urine output, postural dizziness, weakness and fatigue. Signs of dehydration
Patients present with increased thirst, reduced urine output, postural dizziness, weakness and fatigue.

Investigations - Diagnosis

Fact Explanation
Microscopic examination Either a smear of stool sample or scrapings from the periphery of ulcers obtained during an endoscopic examination can be used to demonstrate the presence of organisms or cysts. Microscopic examination
Either a smear of stool sample or scrapings from the periphery of ulcers obtained during an endoscopic examination can be used to demonstrate the presence of organisms or cysts.
Chest X-ray Chest X-ray may show pulmonary parenchymal involvement. Chest X-ray
Chest X-ray may show pulmonary parenchymal involvement.
Computed tomography (CT) CT shows the involvement of pulmonary parenchyma, lymph nodes and other organs and also confirms the findings seen in chest X-ray. Computed tomography (CT)
CT shows the involvement of pulmonary parenchyma, lymph nodes and other organs and also confirms the findings seen in chest X-ray.
Colonoscopy Allows obtaining tissue specimens for the diagnosis of colonic involvement. Colonoscopy
Allows obtaining tissue specimens for the diagnosis of colonic involvement.
Bronchoalveolar lavage Used in diagnosing pulmonary parenchymal involvement. Bronchoalveolar lavage
Used in diagnosing pulmonary parenchymal involvement.

Management - Supportive

Fact Explanation
Health education Disease is transmitted via the feco oral route. Health education should address hygienic measures to prevent the disease transmission and include washing hands with soap and water before cooking or eating and after using toilets. Raw vegetables and fruits should be washed before consumption. Health education
Disease is transmitted via the feco oral route. Health education should address hygienic measures to prevent the disease transmission and include washing hands with soap and water before cooking or eating and after using toilets. Raw vegetables and fruits should be washed before consumption.
Fluid replacement Oral or intravenous fluid replacement is necessary to treat dehydration. Fluid replacement
Oral or intravenous fluid replacement is necessary to treat dehydration.
Electrolyte replacement Electrolyte homeostasis should be maintained. Electrolyte replacement
Electrolyte homeostasis should be maintained.
Appendectomy If appendicitis is present patients may benefit from appendectomy. Appendectomy
If appendicitis is present patients may benefit from appendectomy.

Management - Specific

Fact Explanation
Antibiotics Antibiotics that are frequently used are tetracycline (500 mg orally four times daily for 10 days), metronidazole (500-750 mg orally three times daily for 5 days) and iodoquinol (650 mg orally three times daily for 20 days). Antibiotics
Antibiotics that are frequently used are tetracycline (500 mg orally four times daily for 10 days), metronidazole (500-750 mg orally three times daily for 5 days) and iodoquinol (650 mg orally three times daily for 20 days).
Nitazoxanide Nitazoxanide (500 mg orally twice daily for 3 days) is a broad-spectrum antiparasitic and antihelminthic drug used in treatment of balantidiasis. Nitazoxanide
Nitazoxanide (500 mg orally twice daily for 3 days) is a broad-spectrum antiparasitic and antihelminthic drug used in treatment of balantidiasis.

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