Korean J Clin Microbiol.  2010 Dec;13(4):178-181. 10.5145/KJCM.2010.13.4.178.

A Case of Pneumonia Caused by Balantidium coli in an Immunocompetent Patient

• Lee KS
• Park DS
• Cho JH
• Kim HY
• Lee YJ

• KMID: 1461614
• DOI: http://doi.org/10.5145/KJCM.2010.13.4.178

Abstract

Balantidium coli is the only largest ciliated protozoon known to infect human and nonhuman primates. Balantidiasis is a zoonotic disease and is acquired by humans via fecal-oral contact between pigs and humans. The clinical manifestation includes mainly gastrointestinal symptoms; diarrhea and abdominal pain, but in rare cases extraintestinal spread to lungs has been reported. A few reports of B. coli were found in vaginal secretion, skin, gastric juice, and omentum, but there have been no previous isolated cases in the respiratory tract in Korea. We reported that the first case of pneumonia caused by B. coli in Korea in an immunocompetent 40-year-old woman who displayed symptoms of chest discomfort and cough, and was cured with metronidazole.

Keyword

Balantidium coli; Pneumonia; Metronidazole

MeSH Terms

Abdominal Pain
Adult
Balantidiasis
Balantidium
Cough
Diarrhea
Female
Gastric Juice
Humans
Korea
Lung
Metronidazole
Omentum
Pneumonia
Primates
Respiratory System
Skin
Swine
Thorax
Metronidazole

Figure

• 

  Fig. 1. Radiologic finding of organizing pneumonia at left upper lung field. (A) Chest PA showed segmental distribution of air space consolidation at the left upper lung field. (B) Chest CT showed air space consolidation and atelectasis at lingular division of left upper lung.

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  Fig. 2. Microscopic finding of Balantidium coli. (A) Oval shaped trophozoites has covered whole body with short cilia (arrow) in bronchial brush (×400, wet smear). (B) The trophozoite showed macronucleus and indistinct cilia (×400, PAP stain).

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  Fig. 3. Flexible bronchoscopy showed severe mucosal inflammation with purulent secretion in the lingular segment of left upper lobe bronchus.

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