Intestinal perforation and perianal ulcer due to parasitic infection

Authors

DOI:

https://doi.org/10.22516/25007440.715

Keywords:

Intestinal perforation, Balantidiasis, Balantidium, Parasites, Pediatrics

Abstract

Balantidium coli is the largest protozoan and the only ciliated parasite that infects humans. It causes balantidiasis, a disease humans acquire by fecal-oral transmission from its usual host: the pig. We report the case of an immunocompetent schoolgirl who presented with peritonitis due to intestinal perforation, with perianal ulceration secondary to polyparasitism caused by Balantidium coli, Enterobius vermicularis, and Trichuris trichiura. It is a rare, potentially preventable complication with extremely high mortality rates. The patient required eight surgical interventions.

Downloads

Download data is not yet available.

Author Biographies

Hardenson Rodríguez González, Universidad de Antioquia

Médico y cirujano, residente de pediatría. Medellín, Colombia.

Alejandra Wilches Luna, Hospital Universitario San Vicente Fundación

Pediatra, Gastroenteróloga. Docente Universidad de Antioquia. Medellín, Colombia.

Vanessa Valenzuela Peralta, Universidad de Antioquia.

Médico y cirujano, residente de pediatría. Medellín, Colombia.

Rosalba Vivas Troches, Clínica Soma

Infectóloga pediatra. Medellín, Colombia.

Claudia Liliana Losada Gómez, Hospital Universitario San Vicente Fundación

Pediatra, Gastroenteróloga y hepatóloga pediatra. Docente Universidad de Antioquia. Medellín, Colombia.

References

Hotez PJ. Balantidium coli Infection. En: Cherry J, Demmler-Harrison GJ, Kaplan SL, Steinbach WJ, Hotez P (editores). Feigin and Cherry’s textbook of pediatric infectious diseases. 8.ª edición. Elsevier. 2020. p. 2138-9.

Schuster FL, Ramirez-Avila L. Current world status of Balantidium coli. Clin Microbiol Rev. 2008;21(4):626-38. https://doi.org/10.1128/CMR.00021-08

Gómez Hinojosa PÚ, Espinoza-Ríos J, Carlin Ronquillo A, Pinto Valdivia JL, Salas Dueñas Y, Zare Morales W. Balantidiasis colónica: reporte de un caso fatal y revisión de la literatura. Rev Gastroenterol Peru. 2019;39(3):284-7.

Schär F, Inpankaew T, Traub RJ, Khieu V, Dalsgaard A, Chimnoi W, et al. The prevalence and diversity of intestinal parasitic infections in humans and domestic animals in a rural Cambodian village. Parasitol Int. 2014;63(4):597-603. https://doi.org/10.1016/j.parint.2014.03.007

Balantidiasis [Internet]. Centers for Disease Control and Prevention; 2019 [consultado el 27 de enero de 2020]. Disponible en: https://www.cdc.gov/dpdx/balantidiasis/index.html

Esteban JG, Aguirre C, Angles R, Ash LR, Mas-Coma S. Balantidiasis in Aymara children from the northern Bolivian Altiplano. Am J Trop Med Hyg. 1998;59(6):922-7. https://doi.org/10.4269/ajtmh.1998.59.922

Urbina D, Arzuza O, Young G, Parra E, Castro R, Puello M. Rotavirus type A and other enteric pathogens in stool samples from children with acute diarrhea on the Colombian northern coast. Int Microbiol. 2003;6(1):27-32. https://doi.org/10.1007/s10123-003-0104-5

Mcleod C, Smith P, Mcguinness SL, Francis JR, Baird RW. Human case of Balantidium infection in Australia. Pathology. 2015;47(6):603-4. https://doi.org/10.1097/PAT.0000000000000313

Woody NC, Woody HB. Balantidiasis in infancy. Review of the literature and report of a case. J Pediatr. 1960;56(4):485-9. https://doi.org/10.1016/S0022-3476(60)80361-7

Bellanger AP, Scherer E, Cazorla A, Grenouillet F. Dysenteric syndrome due to Balantidium coli: A case report. New Microbiol. 2013;36(2):203-5.

Schuster FL, Visvesvara GS. Amebae and ciliated protozoa as causal agents of waterborne zoonotic disease. Vet Parasitol. 2004;126(1-2):91-120. https://doi.org/10.1016/j.vetpar.2004.09.019

Anargyrou K, Petrikkos GL, Suller MTE, Skiada A, Siakantaris MP, Osuntoyinbo RT, et al. Pulmonary Balantidium coli infection in a leukemic patient. Am J Hematol. 2003;73(3):180-3. https://doi.org/10.1002/ajh.10336

Vasilakopoulou A, Dimarongona K, Samakovli A, Papadimitris K, Avlami A. Balantidium coli pneumonia in an immunocompromised patient. Scand J Infect Dis. 2002;35(2):144-6. https://doi.org/10.1080/0036554021000027023

Dhawan S, Jain D, Mehta VS. Balantidium coli: An unrecognized cause of vertebral osteomyelitis and myelopathy. J Neurosurg Spine. 2013;18(3):310-3. https://doi.org/10.3171/2012.11.SPINE12519

Pomajbíková K, Oborník M, Horák A, Petrželková KJ, Grim JN, Levecke B, et al. Novel insights into the genetic diversity of Balantidium and Balantidium-like cyst-forming ciliates. PLoS Negl Trop Dis. 2013;7(3):e2140. https://doi.org/10.1371/journal.pntd.0002140

Ferry T, Bouhour D, De Monbrison F, Laurent F, Dumouchel-Champagne H, Picot S, et al. Severe peritonitis due to Balantidium coli acquired in France. Eur J Clin Microbiol Infect Dis. 2004;23(5):393-5. https://doi.org/10.1007/s10096-004-1126-4

Drugs for parasitic infections. Treat Guidel Med Lett. 2013;11(Suppl):e1-31.

García Laverde A, De Bonilla L. Clinical trials with metronidazole in human balantidiasis. Am J Trop Med Hyg. 1975;24(5):781-3. https://doi.org/10.4269/ajtmh.1975.24.781

Lee RV, Prowten AW, Anthone S, Satchidanand SK, Fisher JE, Anthone R. Typhlitis due to Balantidium coli in captive lowland gorillas. Rev Infect Dis. 1990;12(6):1052-9. https://doi.org/10.1093/clinids/12.6.1052

Guía de práctica clínica basada en la evidencia para la promoción del crecimiento, detección temprana y enfoque inicial de alteraciones del crecimiento en niños menores de 10 años y la promoción del desarrollo, detección temprana y enfoque inicial de las alteraciones del desarrollo en niños menores de 5 años en Colombia. Ministerio de Salud y Protección Social. 2014.

Figura 2. Balantidium coli: trofozoíto en una gota de heces, magnificado x 1000. Nótese los cilios visibles en la superficie celular(5). Imagen tomada de(5).

Published

2022-03-15

How to Cite

Rodríguez González, H., Wilches Luna, A. ., Valenzuela Peralta, V. ., Vivas Troches, R. ., & Losada Gómez, C. L. (2022). Intestinal perforation and perianal ulcer due to parasitic infection. Revista Colombiana De Gastroenterología, 37(1), 90–94. https://doi.org/10.22516/25007440.715

Issue

Section

Case report

Altmetric

Crossref Cited-by logo
Article metrics
Abstract views
Galley vies
PDF Views
HTML views
Other views
QR Code

Some similar items: