Helminthiases / / April 28, 2016
Balantidiasis (Lat.), Diatomaceous dysentery (Russian.), Balantidiosis, balantidial dysentery (Eng.), Balantidiose, dysentery balantidienne (fr.), Dysenteria balantidiana (App.)
Balantidiasis - protozoan disease characterized mainly ulcerativelesions of the colon.Sporadic balantidiasis marked in all countries.In some areas of infestation balantidiums reaches 6,2-8,9% and even 28% (Indonesia).
balantidiasis - infusorian Balantidium coli, exists in the vegetative form and in the form of cysts.The vegetative form reaches a length of 30-200 mm, typically 50-80 mm;width parasite 35-60 microns.just a body covered by a shell (pellicle), through which the cilia act.At the front end B. coli mouth slit in the back - tsitopig (anus).In endoplasma lot of inclusions - red blood cells, fungi, bacteria, starch grains, etc. In the middle of the simplest nucleus -. Macro- and micronucleus.Cysts circular shape with a diameter of 50-70 micrometers thick coating.
main source of infect
Pathological anatomy and pathogenesis
most characteristic feature balantidiasis - focal ulcerative nekroticheekie defects of the colon wall, infiltration and loose deposits on the mucosa.
ulcers tend to have thickened, saped, in the early phase of smooth, later eroded edges.Less commonly, there ulcers with drawn edges.Number of ulcers is from 9 to 3500. They are usually located in the colon, and very rarely in the lower part of the small intestine, penetrate to submucosa, sometimes even muscle and serous layer of the intestinal wall.Possible perforation of ulcers in the stomach cavity with peritonitis.Infiltrates around balantidiums consist of cell round cells, plasma cells, and eosinophils.
balantidiasis in the pathogenesis of primary importance are the simplest organism sensitization and their penetration into the tissue.The latter is due to active movements balantidiums and they release the enzyme hyaluronidase, acting on the intestinal wall.On the evidence of allergy ulcer-necrotic processes in the intestine and the presence of characteristic infiltrates of lymphoid cells and eosinophils.
are four clinical forms balantidiasis: subclinical, acute, chronic recurrent (in the acute stage or in remission) and chronic, without remission.
subclinical balantidiasis proceeds without pronounced intestinal disorders.However, a careful examination of the patient revealed a decrease disability, pain on palpation of the abdomen in the area of the cecum.With sigmoidoscopy sometimes found catarrhal, hemorrhagic, and even ulcerative lesions of the distal intestine.Liver disorders observed light antitoxic, carbohydrate and protein functions.
Acute balantidiasis causing severe abdominal pain, nausea, vomiting, rapid (up to 20 times a day), diarrhea, often with mucus and blood, often the wrong type of fever with chills.There have pain on palpation of the abdomen along the colon, liver enlargement and tenderness, a violation of its functions.In severe forms of the disease stool becomes putrid smell.Face sunken, his eyes sunken.In the blood leukocytosis.With sigmoidoscopy revealed typical balantidiasis ulcers.
Chronic recurrent balantidiasis
Chronic recurrent balantidiasis in the acute stage of a severe form of the disease with the flow close to the sharp balanthidiasis, differing from it in the presence of dystrophic events and more frequent severe hepatomegaly with abnormal liver function.In milder forms of the disease diarrhea 1-2 times a day.The admixture of mucus and blood in the stool is often missing.With sigmoidoscopy often found balantidiaznye ulcers.Relapses last from 7 to 30 days of remission - up to 3-6 months.Chronic balantidiasis different sluggish trend, if left untreated, leads to the depletion of the patient.
Among balantidiasis complications should be mentioned ruptured peritonitis, intestinal bleeding, balantidiazny appendicitis, rectal prolapse as a result of constant straining and tenesmus, adrectal abscesses, very rare liver abscess.
Diagnosis detection in stool vegetative forms balantidiums or cysts.Selecting simple chair with different periodicity.Explore feces accounts for 5 or more times, sometimes after laxative treatment.Cal must be investigated immediately after defecation.Valuable diagnostic methods are sigmoidoscopy.
the differential diagnosis should be considered bacillary dysentery, intestinal amebiasis, ulcerative colitis.The first two diseases are excluded on the basis of the negative results of bacteriological research and Proctologic.For ulcerative colitis is characterized by frequent intestinal bleeding, stool color of meat slops, ground beef.
Prediction and prevention
In severe balantidiasis forecast seriously, especially when complications.
Prevention is the sanitary improvement of populated areas, hygienic maintenance pigsties, personal hygiene measures.