Balantidiaz – the protozoan intestinal infection caused by ciliary infusorians – balantidiya. Clinical manifestations of a balantidiaz serve as reflection of inflammatory and ulcer processes in a large intestine, and are characterized by belly-aches, tenezma, a frequent liquid chair with impurity of blood and pus, weight loss, an intoksikatsionny syndrome. For diagnosis "" results of a rektoromanoskopiya, detection in excrements and dabs have importance kliniko-epidemiological yielded. Etiotropny therapy of a balantidiaz is carried out by metronidazole, tinidazoly, tetracycline antibiotics, monomitsiny.
Balantidiaz (dysentery infusorial) – the zoonozny protozoan infection proceeding with the phenomena of ulcer and hemorrhagic colitis and general intoxication. Flashes of a balantidiaz arise in the southern regions more often, however sporadic cases of an infection are also registered in rural areas with the developed pig-breeding. Balantidiaz is characterized by a heavy current, and at a late initiation of treatment - the high lethality caused by intestinal complications, a kakheksiya, accession of sepsis. Distribution of a balantidiaz is promoted by lack of vigilance from medical experts to this pathology, the low level of sanitary culture of the population, a high invazirovannost of country people (4-5%).
Reasons of a balantidiaz
The ciliary infusorian of Balantidium coli acts as the Etiologichesky agent of a balantidiaz. Balantidiya are the largest representatives of intestinal protozoa parasitizing in a human body. Their life cycle passes 2 stages – tsistny and vegetative. Tsista of balantidiya have diameter about 50 microns, rounded shape and can keep viability out of the owner's organism within 3-4 weeks. Length of vegetative forms of parasites - 30-150 microns, width - 30-100 microns; the surface is covered with eyelashes thanks to which the movement is carried out. In the external environment vegetative forms are less steady – perish in 3-5 hours.
As the main tank of activators of a balantidiaz serve pigs among whom the invasion reaches 60-80%; more rare the person acts as a source of a protozoan infection. The infection mechanism balantidiazy – fecal and oral. Transfer of balantidiya (is more often than tsistny forms) happens through dirty hands, kontaminirovanny water, fruit, vegetables. More often balantidiazy employees of pig farms, slaughterhouses, meat shops get sick. In a digestive tract of the person from a tsist vegetative forms which parasitize in fabrics blind, sigmovidny and a rectum are formed. On the place of their introduction in mucous a thick gut, sites of hyperaemia and hypostasis which are transformed further to erosion and ulcers are formed. Defects of a mucous membrane have the crateriform form, uneven edges, the bottom covered with necrotic masses. Ulcer and destructive changes in intestines, absorption of toxic substances, and also food of parasites at the expense of the owner make a basis of pathogenesis of a balantidiaz and define its clinical manifestations.
Symptoms of a balantidiaz
From the infection moment prior to a demonstration of a balantidiaz there pass 1-Z weeks. On expressiveness of clinical manifestations distinguish an asymptomatic (subclinical) and manifest form of a balantidiaz, on character of a current – sharp, chronic and recidivous; on weight of a current – easy, medium-weight and heavy.
At a subclinical form dysfunction of intestines and intoxication are absent, and is distinguished on the basis of an endoscopic picture and laboratory data. The symptomatology of a sharp manifest form of a balantidiaz reminds dysentery. Patients complain of the progressing weakness, a headache, febrilny fever, nausea and vomiting. At the same time symptoms of colitis develop: the cutting belly-aches, diarrhea, tenezma. The chair becomes liquid, mucopurulent, and then bloody; till 15-20 once a day become frequent; excrements have a putrefactive smell. At a severe form of a balantidiaz there is a rapid loss of body weight, up to a kakheksiya.
Chronic proceeds with poorly expressed intoksikatsionny syndrome which is speeded up (to 2-5 times a day) a liquid chair, a meteorizm, morbidity of the blind and ascending gut at a palpation. Sharp and continuously chronic current of a balantidiaz can lead to development of intestinal and extra intestinal complications: bleedings, perforation of ulcers of a thick gut, loss of a rectum, peritonitis, abscesses of a liver, gipokhromny anemia. Without specific etiotropny treatment at a sharp form of a balantidiaz the risk of a lethal outcome is very high. Extremely heavy current of a balantidiaz is noted at its combination to helminthoses and sharp intestinal infections.
Diagnostics and treatment of a balantidiaz
Patients with suspicion on go to the infectiologist. The disease can be suspected on the basis of positive data of the epidemiological anamnesis and clinical manifestations; final confirmation and verification of the diagnosis perhaps after carrying out an endoscopic research of intestines and laboratory analyses.
In a sharp stage of a balantidiaz at a rektoromanoskopiya or a kolonoskopiya focal infiltrative and ulcer changes of a wall of a gut are found; at a chronic current - catarrhal and hemorrhagic or ulcer defeats. As the authentic proof of a balantidiaz serves existence of vegetative forms of balantidiya in svezhevydelenny excrements or in scrapes from affected areas of a gut. The tsist indicates identification a tranzitorny carriage of a protozoan infection. During diagnostics differentiate with bacterial dysentery, amebiazy, lyambliozy, kriptosporidiozy, dysbacteriosis, nonspecific ulcer colitis.
Patients with confirmed balantidiazy are subject to hospitalization in an infectious hospital. As etiotropny therapy are appointed antibacterial (, , ampicillin) or antiprotozoan medicines (metronidazole, ). 2-3 five-day cycles of therapy are usually carried out. System medicinal therapy can be added with enemas with colloido-dispersion salt of a norsulfazol. Dezintoksikatsionny therapy, vitamin therapy, observance of a rational diet is at the same time shown.
Treatment of carriers of a protozoan infection is also strictly obligatory. Lack of a kolitichesky syndrome, a negative koprologichesky research on balantidiya, lack of ulcer changes of an intestinal wall are considered as criteria of treatment of a balantidiaz.
Forecast and prevention of a balantidiaz
The methods of specific treatment of a balantidiaz applied today promote recovery of patients. In case of late begun or inadequate treatment the lethality can reach 10-12%. Prevention of a balantidiaz consists of observance of measures of individual safety (respect for personal hygiene, boiling of water, washing of vegetables and fruit and so forth), and also protection of the external environment from fecal pollution (protection of reservoirs, improvement of zoohygienic conditions of keeping of pigs, manure neutralization, etc.). Specific prevention of a balantidiaz is not developed.