BALANTIDIUM COLI infection, immune status and comorbidities: literature review

Abstract

Balantidiasis, a disease caused by the ciliated protozoan Balantidium coli, mainly infects thelarge intestine and may present intestinal spread. The purpose of this literature review was to study the infection by B. coli and comorbidities to identify the factors that can contribute to the establishment of the disease. In this review, we attempt to explore and describe the various comorbidities associated with B. coli infection. We reviewed the literature based on comorbidities with a focus on the association with B. coli infection. The primary platforms targeted were PubMed, LILACS, SciELO and Google Scholar. Studies published between 1990 and 2020 in Portuguese, English, and Spanish were considered. The comorbidities reported in the papers were diverse, associating infection by B. coli with the immunosuppression that they generate. The intestinal microbiota may also play an important role, because when dysbiosis is present, its composition and structure are affected, which may enable the invasion of the mucosa. The review shows that the presence of the parasite and establishment of balantidiasis can influence in the clinical stage of chronic and autoimmune diseases, considering themodulation of the immune response in presence of B. coli.KEY WORDS: Balantidium coli; autoimmunity; balantidiosis; comorbidities; immunodepression.

Uninvited guest, Balantidium coli in urine in a patient with bladder cancer: A case report and review of the literature

“…Immunodeficiency, alcoholism, and malnutrition are critical risk factors. 1,10,11 Clinical signs can appear in one of three ways: Asymptomatic or occasional constipation and diarrhea, acute mucus-bloody diarrhea, or chronic non-bloody diarrhea alternating with constipation and non-specific abdominal pains. 12 Huge size, oval-shaped, circumferential cilia and rapid spiral motion are the main morphological features of B. coli trophozoites, which facilitate diagnosis.…”

“…Additionally, it has also been reported to colonize the urinary tracts of dialysis patients. [1][2][3][4]9,20 Balantidiasis can affect several hosts, particularly those with chronic-degenerative diseases or compromised immune systems. Immunodeficiency, alcoholism, and malnutrition are critical risk factors.…”

“…It is believed that genitourinary site infections, such as uterine infection, vaginitis, and cystitis, are spread directly from the anal area or as a result of rectovaginal fistulas, which are developed due to B. coli infection. Additionally, it has also been reported to colonize the urinary tracts of dialysis patients 1–4,9,20 …”

“…Balantidiasis typically has no symptoms, but when it does, the manifestations include diarrhea, abdominal cramps, fever, nausea, and vomiting. More severe disease consequences and extraintestinal involvement often affect individuals with immune deficiency and underlying diseases 1–4 . Herein, we report a case of bladder cancer with B. coli in urine.…”

Identification of potentially zoonotic parasites in captive orangutans and semi‐captive mandrills: Phylogeny and morphological comparison

“…Some cases of balantidiosis can be even fatal (Lankester et al, 2008; Strait et al, 2012). The intensity of infection can be affected by a diet rich in starch (Schovancová et al, 2013) and also by stress, which generally leads to immunosuppression (de Oliveira et al, 2022). Balantioides coli is transmitted directly between individuals via the fecal–oral route, but one of the main sources of the infection can be domestic pigs ( Sus scrofa domestica ) and wild boars ( Sus scrofa ) (Schuster & Ramirez‐Avila, 2008).…”