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

Abstract

BACKGROUNDBalantidium coli is a ciliated protozoan that can infect various mammals, including pigs and humans. Human infection (balantidiasis) is brought feco-orally by consuming infective cysts with food and water. The trophozoites afterward mature and remain active in the intestinal lumen. 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][2][3][4] Herein, we report a case of bladder cancer with B. coli in urine. | CASE PRESENTATIONA 71-year-old Iranian woman was transferred to our center with fever, chills, and flank pain for a week. One year earlier, she underwent transurethral resection of the bladder (TURB) for a bladder lesion. The pathologic report declared invasive high-grade urothelial carcinoma, but she did not accept to do chemotherapy and surgery for cystectomy. After that, she was relatively well until 3 months ago when she presented with oliguria and abdominal pain. Sonography revealed severe bilateral hydronephrosis in addition to the advanced tumoral process in the pelvic cavity. Bilateral nephrostomy tubes were inserted, and she was discharged from the hospital. She had no