Balantidium coli is the largest and probably least common protozoan pathogen of humans. It produces a similar spectrum of disease to that of amoebiasis, including severe, life-threatening colitis. Fatalities are almost invariably associated with diagnostic imprecision. B. coli infects many mammals other than man, particularly pigs and monkeys, the pig being the most important animal reservoir for human disease.
The most commonly used treatment for B. coli is tetracycline 500 mg four times daily for 10 days. The parasite is also sensitive to bacitracin, ampicillin, metronidazole and paramomycin. Surgery can be required in fulminant colitis, as in amoebiasis, although a conservative approach should be taken wherever possible.
Nat Clin Pract Gastroenterol Hepatol. 2006;3(8) © 2006 Nature Publishing Group
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