Urinary balantidiasis in a patient with systemic lupus erythematosus and lupus nephritis: a case report

Abstract

Background Balantidium coli, a parasitic unicellular ciliate, often causes asymptomatic balantidiasis of the colon, but extraintestinal disease may occur rarely in immunosuppressed individuals. Renal balantidiasis associated with systemic lupus erythematosus has not been reported before. Case presentation We present a case of a 48-year-old Thai woman who presented with nephrotic syndrome due to systemic lupus erythematosus–related nephritis. Initially, few B. coli cysts were found in urine sediment, but these increased substantially following treatment with prednisolone. She made an uneventful recovery with 10 days of oral tetracycline therapy. No B. coli cysts were found in her stool. Conclusion The route of infection in our patient was unclear but is likely to have been orofecal. Neither her infection nor its treatment caused a deterioration in her renal function.

Prevalence and risk factors of human Balantidium coli infection and its association with haematological and biochemical parameters in Ga West Municipality, Ghana

“…Reduction in haemoglobin and red blood cell levels together with increased mean cell volume was suggestive of megaloblastic anaemia mostly caused by deficient of vitamin B-12 and /or folate. Similar findings were observed in B. coli infected patients in Venezuela [ 27 ] and recently in Thailand [ 28 ]. Significant thrombocytopenia was evident in B. coli infected individuals which was worsened in co-infection state.…”

Food and Drinking Water as Sources of Pathogenic Protozoans: An Update

“…The number of cases and outbreaks of waterborne and foodborne protozoan infections published for each pathogen since 2019 are shown in Figure 2. [8,9,19,35,122,123,[131][132][133]142,143,154,157,[168][169][170]172,173,191,193,195,196,[198][199][200][201]209,226,233,237,[239][240][241][242][243]255,256,260,268,269,273,274,280,282,286]. Outbreaks are only shown for Cryptosporidium species.…”

“…A symptomatic case regarded a 48-year-old Thai woman with a 3-month history of intermittent swelling of both lower limbs who was found to be affected by a urinary tract infection caused by B. coli. The patient had no direct contact with pigs, but most probably ingested cysts through water or food, possibly an undercooked grilled pig intestine dish popular in some parts of Thailand [282].…”

Balantidium coli; Rare and Accidental Finding in the Urine of Pregnant Woman: Case Report

“…Currently, there are about eleven documented cases of urinary balantidiasis reported globally. Single cases reported from Iran, 21 Italy, 25 Slovenia 26 and Thailand 27 while, seven cases were reported from India ( Table 1 ). 20 , 28–32 …”