|
Intestinal damage resulting from B.hominis infection:
This finding supports the view that Intestinal Permeability increases during the course of protozoan infections which cause damage to the intestinal wall while non-pathogenic protozoan infections have no effect on IP. The increase in IP in patients with B. hominis brings forth the idea that B. hominis can be a pathogenic protozoan.
Protozoon infections and intestinal permeability.
Dagci H, et al. Acta Trop 2002 Jan;81(1):1-5
B. hominis & colitis :
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.
Blastocystis hominis complicating ulcerative colitis. J.of the Royal Soc. of Med (Vol 84 Oct. 91)
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.
Presumptive evidence for Blastocystis hominis as a cause of colitis.
Arch Intern Med 1988 May;148(5):1064
B.hominis was detected in the child's stool sample but not treated:
"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.". Jan 02
D.fragilis & colitis:
Clinical reports have suggested that Dientamoeba fragilis may be a cause of acute and chronic colitis in children and adults. The mechanism by which this parasite process produces colitis has not been determined. The clinical findings of this report suggest that D.fragilis causes colitis through an invasive ulcerating process.
Shein R. Gelb.A. Colitis due to dientamoeba fragilis. Am. J Gastroenterol. 1983; 78(10): 634-6
D Fragilis is thought to inhabit the mucosal crypts of the large intestine.
Although it is considered to be non-invasive one case of colitis attributed to this organism has been reported .
Dientamoeba fragiis: a bowel pathogen? Robert Oxner et al. New Zealand Medical Journal. 11 Feb. 87
Dientamoeba fragilis is a rare cause of chronic infectious diarrhoea and colitis in children...... Eosinophilic colitis documented by colonoscopy, was due to D. fragilis .....
CONCLUSION: D. fragilis should be included in the differential diagnosis of chronic diarrhoea and eosinophilic colitis.
Dientamoeba fragilis masquerading as allergic colitis. Cuffari C, Oligny L, Seidman EG Department of Pediatrics, Hopital Sainte-Justine, Universite de Montreal, Canada J Pediatr Gastroenterol Nutr 1998 Jan;26(1):16-20 . Eur J Pediatr 1997 Jul;156(7):583
Arthritis and parasites:
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.
Blastocystis hominis as a rare arthritogenic pathogen. Kruger K, et al. Z Rheumatol 1994 Mar-Apr;53(2):83-5
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.
Infective arthritis due to Blastocystis hominis.
Lee MG, Rawlins SC, Didier M, DeCeulaer K., Ann Rheum Dis 1990 Mar;49(3):192-3
Other published cases of arthritis:
Reactive arthritis from Blastocystis hominis. Arthritis Rheum 1991 Feb;34(2):251-3, Lakhanpal S, Cohen SB, Fleischmann RM.
We report a case of hemorrhagic proctosigmoiditis believed to be caused by B. hominis infection.
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.
Hemorrhagic Proctosigmoiditis and Blastocystis hominis Infection [Letter] Carrascosa et al
Annals of Internal Medicine Volume 124(2) 15 January 1996 pp 278-279
Bowel Inflammation
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.
Blastocystis hominis modulates immune responses and cytokine release in colonic epithelial cells
by H.Y. Long et al (Parasitology Res (2001) 87: 1029-1030)
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)
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.
Blastocystis hominis--past and future.
Zierdt CH. Clin Microbiol Rev 1991 Jan;4(1):61-79
"I've had numerous hospital procedures to be told that there appears an inflamed area of my bowel, but nothing could be detected. Instead I was diagnosed with a stress disorder and given tranquillisers for two years. During this time I had chronic fatigue, headaches, sore throats, chronic bowel pain and wind...yet the doctors prescribe me with more stress related chemicals."
emailed by J Feb 01. Specialised stool testing diagnosed Dientamoeba fragilis.
Blocked bowel:
The family friend of a 7 year old boy 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 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 suffered "nausea, fullness, bloating, intermittent diarrhea and constipation" A single stool sample was positive for Blastocystis hominis. However, because a subsequent stool sample a few weeks later was negative (see Testing) she was diagnosed with IBS. The parasite was not treated. 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."
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, and has been reported by many people suffering a B.hominis and/or D.fragilis infection:
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.
Urticaria by Blastocystis hominis.
Armentia A, et al. Allergol Immunopathol (Madr) 1993 Jul-Aug;21(4):149-51 |
