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The main reservoir of balantidiasis pathogens are pigs, among which invasion reaches 60-80%; less commonly, humans are the source of protozoal infection. The mechanism of infection with balantidiasis is fecal-oral. The transmission of balantidia (usually cystic forms) occurs through dirty hands, contaminated water, fruits, and vegetables. More often, workers of pig farms, slaughterhouses, and meat shops fall ill with balantidiasis. In the human digestive tract, cysts form vegetative forms that parasitize in the tissues of the blind, sigmoid and rectum. At the site of Methotrexate introduction into the colon mucosa, areas of hyperemia and edema are formed, which later transform into erosions and ulcers. Mucosal defects are crater-shaped, uneven edges, bottom covered with necrotic masses. Ulcerative-destructive changes in the intestine, the absorption of toxic substances, as well as the nutrition of parasites at the expense of their host form the basis of the pathogenesis of balantidiasis and determine its clinical manifestations.
The etiological agent of balantidiasis is the ciliary ciliate Balantidium coli. Balantidia are the largest representatives of intestinal protozoa that parasitize in the human body. Their life cycle goes through 2 stages - cystic and vegetative. Balantidia cysts are about 50 µm in diameter, round in shape, and can survive outside the host for 3-4 weeks. Length of vegetative forms of parasites - 30-150 microns, width - 30-100 microns; the surface is covered with cilia, thanks to which movement is carried out. In the external environment, vegetative forms are less stable - they die after 3-5 hours.
From the moment of infection to the manifestation of balantidiasis, 1-3 weeks pass. According to the severity of clinical manifestations, there are asymptomatic (subclinical) and manifest forms of balantidiasis, according to the nature of the course - acute, chronic and recurrent; according to the severity of the course - light, moderate and heavy.