Balantidium Pathogenesis and Balantidiasis

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Questions and Answers

What is the primary mechanism of tissue invasion by Balantidium coli?

Via the action of hyaluronidase (correct)

Through direct contact with intestinal mucosa

By inducing a striking inflammatory reaction

Through production of proteolytic enzymes

What is the most common clinical form of balantidiasis?

Fulminating

Chronic (correct)

Extraintestinal

Acute

What is a potential symptom of balantidiasis that resembles amebic dysentery?

Severe headaches

Mild colitis

Nausea

Severe and marked fluid loss (correct)

What is the primary mode of transmission of Balantidium coli?

Through direct or indirect contact with pig fecal matter Signup and view all the answers

What is a potential complication of acute balantidiasis in immunocompromised individuals?

All of the above Signup and view all the answers

What is the typical shape of ulcers in the intestinal mucosa caused by Balantidium coli?

Flasked shape Signup and view all the answers

What is the shape of the trophozoite?

Ovoid Signup and view all the answers

What is the function of the micronucleus in the trophozoite?

Cell division and genetics Signup and view all the answers

What triggers the encystation process in the trophozoites?

Dehydration of intestinal contents Signup and view all the answers

What is the primary site of infection in the host?

Large intestine Signup and view all the answers

What is the function of the adoral cilia around the mouth of the trophozoite?

Feeding and digestion Signup and view all the answers

What is the characteristic of the cyst wall that allows it to resist degradation in the stomach?

Double layer with refractile property Signup and view all the answers

What is the primary method for diagnosing Balantidium coli?

Microscopic examination of a patient's feces Signup and view all the answers

What is the treatment of choice for balantidiasis?

Tetracycline Signup and view all the answers

What is the significance of collecting stool samples frequently and examining them immediately?

Because Balantidium coli is passed periodically Signup and view all the answers

What can be detected in tissue specimens collected through a sigmoidoscopy procedure?

Trophozoites of Balantidium coli Signup and view all the answers

What is the purpose of a sigmoidoscopy procedure in diagnosing balantidiasis?

To visualize the large intestine to diagnose the cause of diarrhea Signup and view all the answers

What can be revealed through imaging studies, such as chest radiography and CT scans, in patients with balantidiasis?

All of the above Signup and view all the answers

Study Notes

Trophozoite Characteristics

Size variation: Smaller (42-60 μm in length, 30-40 μm in width) and larger (80-120 μm in length, 60-80 μm in width).
Shape: Ovoid with a narrow anterior end featuring structures such as peristome, cytostome, and cytopharynx, and a broad posterior end.
Surface: Covered by delicate short cilia, with larger adoral cilia around the mouth.

Nuclei

Macroneucleus: Located centrally, can be spherical, ellipsoid, curved, or kidney-shaped.
Microneucleus: Near macroneucleus, small and spherical, involved in genetics and cell division.

Cytoplasm and Vacuoles

Contains contractile vacuoles, indicating osmoregulatory functions.

Cyst Characteristics

Forms: Spherical or ellipsoid, measuring 50-75 μm in length.
Structure: Thick double-layered wall includes macroneucleus, microneucleus, and vacuoles.
Infection route: Occurs when a host ingests a cyst from contaminated water or food.

Life Cycle

Cysts are protected from stomach acid; upon reaching the small intestine, they transform into trophozoites.
Trophozoites colonize the large intestine, feeding on intestinal flora.
Some trophozoites invade the colon wall using proteolytic enzymes.
Encystation occurs in response to dehydration, often in the distal large intestine or in feces.

Diagnosis

Microscopic examination of feces is essential; stool samples need to be collected frequently for reliable results.
Detection of cysts or trophozoites in feces or through tissue biopsy using sigmoidoscopy.
Imaging studies may reveal pulmonary involvement through chest X-ray or CT scans.

Treatment

Empiric antimicrobial therapy is necessary; tetracycline is the primary drug, followed by metronidazole and iodoquinol.
Hospital treatment may include volume and electrolyte replacement therapy.

Balantidiasis Overview

Caused by Balantidium coli, leading to intestinal inflammation.
Transmission commonly occurs through contact with pig fecal matter.
Symptoms may include diarrhea (watery, bloody, mucoid), nausea, vomiting, abdominal pain, weight loss, and fever.

Clinical Forms of Balantidiasis

Chronic: Characterized by alternating diarrhea and constipation.
Acute: Resembles amoebic dysentery, prevalent in immunocompromised individuals, potentially causing complications like appendicitis and perforations.
Extraintestinal: Rare but can lead to other infections.

Pathogenesis

Pathogenic features include flask-shaped ulcers with normal mucosa in between.
Potential for secondary bacterial infections and significant inflammatory reactions around trophozoites.

Key Questions

Sporozoans reproduce through asexual and sexual cycles, often involving multiple hosts.
Toxoplasma can be transmitted through ingestion of contaminated food or water, contact with cat feces, or congenital transmission.
Intermediate hosts for Toxoplasma gondii include rodents and birds.
The infective stage of Cryptosporidium is the oocyst.
Balantidium causes intestinal ulcers via enzyme production, leading to inflammation and potential bacterial invasion.

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Description

Learn about the pathogenesis of Balantidium, a parasitic protozoan that causes intestinal infection, including tissue invasion and ulceration. Understand the role of enzymes like hyaluronidase and the immune response to infection.