Clinical Features:

• "Most cases are asymptomatic. 

• Clinical manifestations, when present, include persistent diarrhea, occasionally  dysentery, abdominal pain, and weight loss. 

•  Symptoms can be severe in debilitated individuals."

Laboratory Diagnosis:

• "Diagnosis is based on detection of trophozoites in stool specimens or in tissue collected during endoscopy. 

• Cysts are less frequently encountered. 

• Balantidium coli is passed intermittently and once outside the colon is rapidly destroyed.  

• Thus stool specimens should be collected repeatedly, and immediately examined or preserved to enhance detection of the parasite."

Treatment:

• The Medical Letter recommends tetracycline (Achromycin) as the drug of choice, with iodoquinol (Yodoxin, Moebequin) and metronidazole (Flagyl) as alternatives. 

  •  Tetracyclines is contraindicated in pregnancy and in children less than 8 years old."

• Courtesy of the Division of Parasitic Diseases at the National Center for Infectious Diseases, Centers for Disease Control and Prevention