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Questions and Answers
What is the primary mechanism of tissue invasion by Balantidium coli?
What is the most common clinical form of balantidiasis?
What is a potential symptom of balantidiasis that resembles amebic dysentery?
What is the primary mode of transmission of Balantidium coli?
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What is a potential complication of acute balantidiasis in immunocompromised individuals?
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What is the typical shape of ulcers in the intestinal mucosa caused by Balantidium coli?
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What is the shape of the trophozoite?
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What is the function of the micronucleus in the trophozoite?
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What triggers the encystation process in the trophozoites?
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What is the primary site of infection in the host?
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What is the function of the adoral cilia around the mouth of the trophozoite?
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What is the characteristic of the cyst wall that allows it to resist degradation in the stomach?
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What is the primary method for diagnosing Balantidium coli?
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What is the treatment of choice for balantidiasis?
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What is the significance of collecting stool samples frequently and examining them immediately?
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What can be detected in tissue specimens collected through a sigmoidoscopy procedure?
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What is the purpose of a sigmoidoscopy procedure in diagnosing balantidiasis?
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What can be revealed through imaging studies, such as chest radiography and CT scans, in patients with balantidiasis?
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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.
