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A patient working at a pig farm complains about paroxysmal abdominal pain, liquid feces with admixtures of mucus and blood, headache, weakness, fever. Examination of large intestine revealed ulcers from 1 mm up to several cm large, feces contained oval unicellular organisms with cilia. What disease should be suspected?
Balantidium coli causes balantidiasis. It is the only ciliated protozoan that causes human disease i.e. diarrhea. Domestic animals, especially pigs are the main reservoir for the organism and humans are infected after ingesting the cysts in food or water contaminated with animal or human faeces. Diagnosis is made by finding large ciliated trophozoites or large cysts with a characteristic V-shaped nucleus in the stool. The trophozoites excyst in the small intestine, travel to the colon (large intestine) and by burrowing into the wall cause an ulcer similar to that of Entamoeba histolytica.