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

Koung-Sun Lee; Do-Sim Park; Ji-Hyun Cho; Hak-Yeol Kim; Young-Jin Lee

doi:10.5145/KJCM.2010.13.4.178

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Lee, Park, Cho, Kim, and Lee: A Case of Pneumonia Caused by Balantidium coli in an Immunocompetent Patient

Original Article

Korean J Clin Microbiol 2010;13(4):178-181.

Published online: 21 December 2010

DOI: https://doi.org/10.5145/KJCM.2010.13.4.178

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

Koung-Sun Lee¹, Do-Sim Park^1,³, Ji-Hyun Cho^1,³, Hak-Yeol Kim^2,³, Young-Jin Lee^1,³

¹Department of Labroatory Medicine, School of Medicine, Wonkwang University, Iksan, Korea

²Department of Internal Medicine, School of Medicine, Wonkwang University, Iksan, Korea

³Department of Wonkwang Medical Science, School of Medicine, Wonkwang University, Iksan, Korea

Correspondence: Young-Jin Lee, Department of Laboratory Medicine, School of Medicine, Wonkwang University, 344-2 Sinyong-dong, Iksan 570-711, Korea. (Tel) 82-63-859-1862, (Fax) 82-63-842-3786, (E-mail) jin20@wku.ac.kr

Received 24 May 2010 Revised 28 July 2010 Accepted 20 August 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Balantidium coli, Pneumonia, Metronidazole

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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.

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).

Fig. 3.

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

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