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• Balantidium coli


  • Formerly known as Paramecium coli
  • Only ciliate known to cause human disease
• Balantidium coli

  
  

  Associated diseases

  • Balantidiasis
  • Balantidiosis
  • Balantidial dysentery
• Balantidium coli

  
  

  Modes of transmission

  • Feco-oral: Ingestion of contaminated food and water
  • Person-person: food handlers
• Balantidium coli

  
  

  Specimen for laboratory diagnosis

  • Stool
  • Sigmoidoscopy material
  • Bronchoalveolar washings
• Balantidium coli

  
  

  Tests for laboratory diagnosis

  • DFS
  • Concentration techniques
• Balantidium coli

  
  

  Incubation period

  1-5 days
• Balantidium coli

  
  

  Acute symptoms

  • Diarrhea
  • Abdominal pain
  • Nausea
  • Vomiting
• Balantidium coli

  
  

  Balantidial dysentery

  Diarrhea with bloody and mucoid stools
• Balantidium coli

  
  

  Chronic symptoms

  • Diarrhea alternates with constipation
  • Abdominal cramps
  • Anemia
  • Cachexia
• Balantidium coli is distributed worldwide but incidence of human infection is very low
• Balantidium coli

  
  

  Treatments

  • Tetracycline
  • Metronidazole
  • Iodoquinol
  • Doxycycline and nitazoxanide
• Balantidium coli

  
  

  Life cycle

  1. Trophozoites multiply via transverse binary fission

  2. Excystation in small intestines

  3. Trophozoites reside and feed in cecal, ileum, lumen, mucosa, and submucosa of large intestine

  4. Encystation in lumen

  
• Isospora belli


  Associated disease: Isosporiasis

  
• Isospora belli

  
  

  Modes of transmission

  • Ingestion of contaminated food and water
• Isospora belli

  
  

  Specimen for laboratory diagnosis

  • Stool
  • Duodenal contents
  • Intestinal biopsies
• Isospora belli

  
  

  Tests for laboratory diagnosis

  • DFS
  • Concentration techniques
  • Permanent stains
• Charcot-Leyden crystals


  May be seen in stool (eosinophilia)
• • isospora belli is found worldwide, mostly in tropical and subtropical countries
  • common in HIV/AIDS patients
• Isospora belli

  
  

  Severe infection symptoms

  • Severe diarrhea
  • Fat malabsorption
• Isospora belli

  
  

  Other symptoms

  • Low-grade fever
  • Anorexia
  • Vomiting
  • Body malaise
  • Weight loss
  • Flatulence
• Isospora belli

  
  

  Treatments

  • Bed rest and bland diet for asymptomatic cases
  • Trimethoprim-sulfamethoxazole for immunocompromised patients
  • Combined therapy with pyrimethamine and sulfadiazine
• Isospora belli

  
  

  Infective stage

  Mature oocyst
• Isospora belli

  
  

  Life cycle

  1. Excystation in small intestines releasing sporozoites

  2. Sporozoites develop in epithelial cells to form a schizont, which ruptures and release merozoites

  3. Some merozoites undergo gametogony to produce macro and microgametes which fuse to form a zygote

  
• Humans are the only known host for Isospora belli
• Sarcocystis spp.

  Species recovered in the Philippines:

  • S. cruzi (cattle)
  • S. levine (water buffaloes)
  • S. miescheriana (domestic pigs)
  • S. capracanis (domestic goats)
• Sacrcocystis spp.

  
  

  
  

  Tests for laboratory diagnosis

  • DFS
  • Histologic techniques
  • Flotation technique
  • Staining with Periodic Acid-Schiff (PAS)
  • PCR
• Symptoms

  • Rare invasive: vasculitis and myositis
  • Intestinal: nausea, abdominal pain, diarrhea
  • Acute: fever, myalgias, bronchospasm, pruritic rashes, lymphadenopathy
• Sarcocystis infection is worldwide but human infection is rare
• Treatments


  • Combined trimethoprim and sulfamethoxazole
  • Combined pyrimethamine and sulfadiazine
• Infective and diagnostic stages

  • Bradyzoites (muscle)
  • Sporocyst (feces)
• Cryptosporidium parvum/hominis


  Associated disease: Cryptosporidosis
• Modes of transmission


  • Ingestion of contaminated food and water
• Specimen for laboratory diagnosis

  • Stool
  • Intestinal biopsy
  • Respiratory samples
• Tests for laboratory diagnosis

  • DFS
  • Flotation techniques
  • Entrotest
  • ELISA
  • Indirect immunofluorescence
  • Kinyoun's modified acid fast stain
• Cryptosporidium is found worldwide and immunocompromised patients are at risk

  
• Symptoms


  • Immunocompetent patients: Diarrhea, fever, nausea, vomiting, weight loss, abdominal pain
  • Immunocompromised patients: severe diarrhea, malabsorption, and may cause infection to other body areas (e.g., respiratory tract)
• Treatments

  • Spiramycin
  • Nitazoxanide
  • Bovine colostrum
  • Paromomycin, clarithromycin, azithromycin
• Infective and diagnostic stage

  Thick walled oocyst
• Two types of oocysts

  • Thin walled - autoinfection
  • Thick walled - passed out of the body
• Cyclospora cayetanensis

  • Thought to be a member of cyanobacteria as it showed characteristics similar to the blue green algae
  • Originally called "cyanobacterium-like body (CLB)"