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Balantidium coli in urine sediment: report of a rare case presenting with hematuria.

ABSTRACT: Balantidium coli (B. coli) is the only trophic ciliate of low virulence causing dysentery in human. However, may be due to their active motility and invasive nature, they have been rarely described to cause infection in extraintestinal sites also. We herein describe a case where trophozoites of B. coli were detected in urinary sediment examination of an elderly female presenting with mild fever, dysuria and hematuria for last 1 week. The parasites were identified by their characteristic morphology and rapid spiraling motility. This is only the third case described in literature to detect B. coli in urine sediment.

SUBMITTER: Bandyopadhyay A

PROVIDER: S-EPMC3793101 | biostudies-literature | 2013 Oct

REPOSITORIES: biostudies-literature

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Balantidium coli in urine sediment: report of a rare case presenting with hematuria.

Bandyopadhyay Arghya A Majumder Kaushik K Goswami Bidyut Krishna BK

Journal of parasitic diseases : official organ of the Indian Society for Parasitology 20120823 2

Balantidium coli (B. coli) is the only trophic ciliate of low virulence causing dysentery in human. However, may be due to their active motility and invasive nature, they have been rarely described to cause infection in extraintestinal sites also. We herein describe a case where trophozoites of B. coli were detected in urinary sediment examination of an elderly female presenting with mild fever, dysuria and hematuria for last 1 week. The parasites were identified by their characteristic morpholo ...[more]

PMID: 24431585

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Project description:Introduction and importanceEchinococcus granulosus causes hydatid disease. The most affected organ is the liver which is followed by the lungs. The pleural cavity being the primary location of hydatid cysts is rare and should be discussed further. This paper documents a rare case of primary pleural hydatidosis which can present with a merely isolated cough followed by dyspnea. The diagnosis and surgical treatment along with post-operative medications are vital in this case.Case presentationWe present a case of a 45-year-old who suffered from a cough for more than one week which did not subside after taking medications. This symptom was followed by dyspnoea for which an X-ray was done which showed left-sided pleural effusion, a complication of pleural hydatidosis. Computed tomography showed multiple cysts in the pleural cavity which confirmed the diagnosis of primary pleural hydatidosis as the cysts were not present in any other sites. Blood work revealed eosinophilia which is significant in parasitic diseases. A left posterolateral thoracotomy was performed, and the cysts were surgically removed. Additionally, empyemectomy and pleurectomy were done. The patient was then treated with anti-parasitic therapy and was advised to get X-rays during the follow-up visits. The X-rays were normal and indicated that there was no disease recurrence.Clinical discussionEchinococcus granulosus is a parasitic worm that causes hydatid disease. The primary location is the liver. A diagnosis of intrathoracic but extrapulmonary disease, which involves the presence of hydatid cysts in the pleura, heart, pericardium, mediastinum, chest wall, and diaphragm, is difficult in individuals lacking a primary cyst in a common location (Isitmangil et al., 2003; Saeedan et al., 2020).ConclusionThis case implies the significance of a cough of more than a week that is not relieved by medications. This should be carefully evaluated and followed in cases that have a rare diagnosis requiring surgery. A diagnosis of primary pleural hydatidosis with left-sided pleural effusion and atelectasis with mediastinal shift to the right side was made which was treated with a surgical procedure.

Project description:Acute abdominal syndrome can be caused by several possible reasons. The most common causes are perforation of a gastroduodenal ulcer, peritonitis, intestinal obstructions, and perforation of an appendix or fallopian tube. Fever and pain can be caused by an appendicitis or sigmoiditis. Appendiceal lymphoma is a rare disease that is usually found incidentally during appendectomy. Most of the cases are non-Hodgkin's lymphomas. Mantle cell lymphoma is an aggressive B-cell non-Hodgkin's lymphoma with a poorer prognosis than other B-cell lymphomas; thus, a definitive diagnosis is essential. A 60-year-old man presented with right lower quadrant pain. He denied any nausea, vomiting or anorexia and was afebrile. The physical examination revealed right lower quadrant abdomen tenderness. The computed tomography scan revealed periappendiceal fatty stranding with a swollen appendix, approximately 2 cm in diameter and prominent paraaortic, portacaval and mesenteric lymph nodes. A diagnosis of acute appendicitis was made, and laparoscopic appendectomy was performed immediately. The subsequent pathological examination revealed severe congestion with lymphoid hyperplasia. The immunohistochemistry stains revealed positive staining for cluster of differentiation (CD) CD20, B-cell lymphoma-2 (Bcl-2), cyclin D1, SRY-box transcription factor-11 (SOX-11), immunoglobulin D (IgD) and immunoglobulin M (IgM) but negative staining for CD3, CD5, CD10 and CD23. 18F-FDG positron emission tomography showed peripheral lymph node involvement, while the bone marrow biopsy showed negative findings. Therefore, a diagnosis of mantle cell lymphoma, Ann Arbor stage IVA, was made. The patient received postoperative combination chemotherapy and remained in a stable condition over a 1-year follow-up period. We report an uncommon case that initially presented as acute appendicitis, for which a final diagnosis of mantle cell lymphoma was made. In comparison with other B-cell lymphomas, mantle cell lymphoma has a poorer prognosis, and positive immunochemical staining of cyclin D1 and SOX-11 is useful for differentiating mantle cell lymphoma from other appendiceal lymphomas and treating patients appropriately. Physicians and nursing staff should be also aware of the associated complications and management in these patients.

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Balantidium coli in urine sediment: report of a rare case presenting with hematuria.

Publications

Balantidium coli in urine sediment: report of a rare case presenting with hematuria.

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