| COLITIS |
Blastocystis
hominis complicating ulcerative colitis
J.of the Royal Soc. of Med (Vol 84 Oct. 91) |
|
The
response of our patient to metronidazole therapy raises the
possibility that other ulcerative colitis patients might benefit
from this treatment and so postpone or avoid the need for major
surgery. We would suggest the examination of stool specimens,
looking specifically for this organism be performed routinely
in ulcerative colitis patients with refractory symptoms. |
Presumptive
evidence for Blastocystis hominis as a cause of colitis.
Arch Intern Med 1988 May;148(5):1064 |
|
A
patient with persistent diarrhea was found to have biopsy-proved
colitis with large numbers of the protozoan Blastocystis hominis
present in stool. Extensive evaluation failed to reveal any
other potential etiologic agent of acute colitis. Following
treatment with a course of metronidazole, the patient became
asymptomatic, B hominis was no longer present in stool, and
results of a repeated biopsy were normal. These observations
are consistent with the role of B hominis as a gastrointestinal
pathogen. |
The
following e-mail was sent by the parents of a child positive
for Blastocystis hominis:
"Your
site was very helpful to us for another reason however. Our
16 year old son who was perfectly well went to camp about a
year ago and returned with bloody mucusy diarrhea. He eventually
lost 30 pounds and had a lengthy hospitalization. WE TRULY BELIEVED
IT WAS A PARASITIC SITUATION DUE TO ITS ABSOLUTE ABRUPT ONSET.
Doctors were quick to diagnose ulcerative colitis at great expense."
L. Jan 02 |
 |
| ARTHRITIS |
Blastocystis
hominis as a rare arthritogenic pathogen.
Kruger
K, et al
Z Rheumatol 1994 Mar-Apr;53(2):83-5
|
|
A
46-year-old female patient developed a chronic diarrhea and
oligoarthritis some days after returning from a trip to Senegal.
Arthritis was refractory against treatment with NSAID and corticosteroids.
Finally, a 3-week course of treatment with metronidazole resulted
in a complete remission of arthritis, gastrointestinal symptoms,
and inflammation signs (ESR, CRP). The course in our case, as
well as the detection of Blastocysts hominis in synovial fluid
in another case, implicate an infectious rather than a reactive
etiology of
arthritis. |
Infective
arthritis due to Blastocystis hominis.
Lee MG, Rawlins SC, Didier M, DeCeulaer K.
Ann Rheum Dis 1990 Mar;49(3):192-3 |
|
A
patient with rheumatoid arthritis taking prednisone developed
Blastocystis hominis acute diarrhea, which was associated
with increased inflammation and effusion of the left knee.
B hominis organisms were found in synovial fluid from the
left knee. The patient responded dramatically to metronidazole
treatment. B hominis may become disseminated in immunosuppressed
patients with diarrhea and may cause infective arthritis.
|
|
Other published cases of arthritis:
Reactive arthritis from Blastocystis
hominis.
Arthritis Rheum 1991 Feb;34(2):251-3
Lakhanpal S, Cohen SB, Fleischmann RM.
|
|
Hemorrhagic
Proctosigmoiditis and Blastocystis hominis Infection [Letter]
Carrascosa et al
Annals of Internal Medicine Volume 124(2) 15 January 1996
pp 278-279 |
| |
We
report a case of hemorrhagic proctosigmoiditis believed to be
caused by B. hominis infection.
CONCLUSION:
...this case provides further evidence to support the pathogenicity
of B. hominis and that this organism should be considered a
possible additional cause of hemorrhagic colitis in both immunocompetent
and immunocompromised persons. |
|
| BOWEL
INFLAMMATION |
|
The following
is an extract from -
Blastocystis hominis modulates immune responses and
cytokine release in colonic epithelial cells
by H.Y. Long et al (Parasitology Res (2001) 87: 1029-1030)
It might be speculated that B.hominis downregulates the host
immune responses in the early phase of the infection, in order
to improve its survival. This seems to be a common evasion
mechanism of parasites, as it has also been demonstrated for
Toxoplasma gondii (Denney et al. 1999). Further it may also
be expected that this effect of B.hominis could indirectly
facilitate the progress of infection by other opportunistic
pathogens. The results presented here indicate that B.hominis
is able to induce and modulate the production of inflammatory
cytokines in intestinal epithelial cells.
Click here to download paper
|
|
The
results presented here indicate that Blastocystis hominis is
able to induce and modulate the production of inflammatory cycotines
in intestinal epithelial cells.
|
Intestinal
inflammation caused by Blastocystis hominis is also described
in the paper –
The Occurrence of Blastocystis hominis
in Intestinal Inflammation
(J.
Am. Med. Assoc
1923 81:522-523)
|
| In
the majority of cases the inflammation resolves after effective
drug treatment: |
Blastocystis
hominis--past and future.
Zierdt CH.
Clin Microbiol Rev 1991 Jan;4(1):61-79 |
|
The
pathology of B. hominis infections has been studied in gnotobiotic
guinea pigs in which inflammation of the intestinal mucosa and
invasion of the superficial layers were seen. Only limited studies
of human pathology are available. Those who have studied mucosal
histopathology report inflammation and cellular changes that
resolve after treatment. |
|
| FATALITY
ASSOCIATED WITH BLASTOCYSTIS HOMINIS INFECTION
|
|
In
1976 a report published in the medical journal – Z.Parasitenkd
– cites the case of a 45 year old alcoholic male infected
with Blastocystis hominis who died of his disease. This man
produced between 5 and 20 litres of dirrhoea daily and required
continuous administration of large volumes of fluids. He was
treated for 7 days with metronidazole, which reduced the amount
of Blastocystis hominis by only one-third. He died shortly after
from aspiration pneumonia. Intensive investigation revealed
no other underlying disease or infective agents.
|
|
| BLOCKED
BOWEL
|
| |
The
following cases of blocked bowel may be only coincidentally
associated with
Blastocystis hominis infection, but nevertheless worth a mention:
A 7 year old boy, was admitted to hospital for a blocked
bowel.
A family friend wrote:
"...the
little guy had a blocked bowel that went undiagnosed
for two days. He didn't present with the usual symptoms. Now
his mom is wondering if he had the infection prior to the bowel
problem. As I have read through some of the stories it sounds
a lot like the trouble he has had for the last year. Anyway
... By the time he got to the hospital (by ambulance), he was
in rough shape. They operated on him and fixed the problem.
No testing at that point assuming that his only problem was
the bowel thing. He comes home on Friday. On Monday he is back
in the hospital with diarrhea. At that point, as far as I can
tell, he is tested and the parasite (Blastocystis hominis
)is detected. "
Another
Blastocystis hominis sufferer also experienced a blocked bowel:
"I ended up in
the hospital with a bowel blockage and when test results
came back one of them detected the parasite blastocystis
hominis"
G. DEC 01
The following woman
had a similar experience. She suffered "nausea,
fullness, bloating, intermittent diarrhea and constipation"
and submitted a single stool sample which tested positive
for Blastocystis hominis However, because a subsequent stool
sample a few weeks later was negative (**see
below) her doctor decided her doctor her symptoms
were probably due to IBS and not the parasite. She wrote:
"I ended up in the hospital with
a bowel blockage. My doctor put me on Dicetel for IBS
and that made be far sicker than I was before I went on it,
I had uncontrollable diarrhea, and the bloating was very uncomfortable.
I now suffer from constipation, bloating and a feeling of fullness
all the time, as well as some heartburn."
She is
still unwell and wrote asking if I could recommend a doctor
who would treat her infection.
**False
negatives can occur even with fixed samples.
In mid 2001 I submitted three fixed samples for testing. All
were positive for both Dientamoeb fragilis & Blastocystis
hominis. Five weeks after drug treatment for D.fragilis (Iodoquinol
& doxycycline) I again submitted three fixed samples for
testing. All three samples were negative for either D.fragilis
or B.hominis.
The previous year I'd heard from others who had tested positive
for Blasto. only after submitting "purged"
samples. Prior testing on fixed, non-purged samples had been
negative.
My three purged samples were now positive for
Blastocystis hominis.
Blastocystis hominis adheres
to the bowel wall and sheds
irregularly in feces.
Click here
for more info. Email me
for info. on submitting purged samples. |
|
HIVES:
Urticaria (hives)
consists of localised swelling on the skin often accompanied
by an itchy rash. The symptoms usually last for a few hours
before eventually fading away.
Angio-oedema is excessive swelling around the eyes or lips
. Many of those who contact me diagnosed with parasites report
rashes and/or swelling on the skin.
|
Urticaria by Blastocystis hominis.
Armentia
A, et al.
Allergol Immunopathol (Madr) 1993 Jul-Aug;21(4):149-51 |
| |
Urticaria
and angioedema are easily recognized disorders, but in at least
70 percent of individuals, chronic episodes of urticaria are
of unknown causes. We present 10 cases of chronic urticaria
associated parasitation by Blastocystis hominis. This parasite
has not been previously related with urticaria. |
|
| DEPRESSION
& ANXIETY DISORDERS ASSOCIATED WITH PARASITIC ILLNESSES: |
| |
Many
who contact me suffering parasitic infections frequently describe
an inability to concentrate, brain fog, depression and panic
disorder which are generally exacerbated when the digestive
symptoms worsen.
"My
experiences have been similar to yours with Blastocystis
hominis et al. At present I am able to work only half
time. Perhaps more troubling than the fatigue is
the brain fog. Ever since Peace Corps India 35
years ago, I have suffered recurrent bouts of various
parasites, often in combination! I have never been tested
for Dientamoeba fragilis. In fact, I only know about it
from your website. "
H. received Jan 02
K,
also diagnosed with Blastocystis hominis wrote:
"I felt vague, forgot words, felt extremely tired,
weak and sick. Wierd head sensations were always present
- felt foggy and unfocussed.
"My
experiences have been similar to yours with Blastocystis
hominis et al. At present I am able to work only half
time. Perhaps more troubling than the fatigue is the
brain fog.".
C Jan 02
|
When compared
with those reporting no gastrointestinal symptoms, subjects
who report at least one of these symptoms were significantly
more likely to have also experienced lifetime episodes
of major depression (7.5% vs 2.9%), panic disorder (2.5%
vs 0.7%), or agoraphobia (10.0% vs 3.6%). Subjects with
two gastrointestinal symptoms had even higher lifetime
rates of depression (13.4%), panic (5.2%), or agoraphobia
(17.8%). Lifetime rates of affective and anxiety disorders
in the general population are higher in subjects with
gastrointestinal symptoms compared with subjects without
gastrointestinal symptoms. An even higher prevalence
of affective and anxiety disorders is found in patients
with medically unexplained gastrointestinal symptoms in
tertiary-care clinics.
Comorbidity
of gastrointestinal complaints, depression,
and anxiety in the Epidemiologic Catchment Area (ECA)
Study.
Am J Med 1992 Jan 24;92(1A):26S-30S
Walker EA, Katon WJ, Jemelka RP, Roy-Bryne PP. |
|
| see
also Chronic Fatigue
Syndrome |
