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 Blastocystis hominis infection

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PostSubject: Blastocystis hominis infection   Blastocystis hominis infection EmptyTue Jan 04, 2011 5:20 pm

Blastocystis hominis (B. hominis) is a
microscopic parasite sometimes found in the stools of healthy people as
well as in the stools of those who have diarrhea, abdominal pain or
other gastrointestinal problems. Infection with B. hominis is called
blastocystosis.

Researchers don't yet fully understand the role that B. hominis plays in
causing an infection. Certain subtypes of this parasite may be more
likely to cause infection, or may pose a risk only when combined with
other types of infection. In some cases, the parasite simply resides in
the digestive tract without causing harm.

There are no proven treatments for Blastocystis, and the infection
usually clears up on its own. However, if signs and symptoms don't
improve, your doctor may recommend trying medications.

©1998-2010 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.
Expand Arrow DownSymptoms

Signs and symptoms that might be associated with blastocystis include:

* Diarrhea
* Nausea
* Abdominal cramps
* Bloating
* Excessive gas (flatulence)
* Anal itching
* Fatigue

When to see a doctor
See your doctor if you have signs and symptoms associated with
blastocystis, such as diarrhea, cramps and fatigue that last longer than
three days.

©1998-2010 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.
Expand Arrow DownCauses

Once thought to be a harmless yeast, B. hominis is a parasite, a
microscopic single-celled organism (protozoan). It behaves like a tiny
animal — hunting and gathering other microbes for food. Many protozoa
inhabit your gastrointestinal tract and are harmless; others cause
disease.

Whether B. hominis is the type of protozoa that causes disease is
controversial. While many people who carry B. hominis have no signs or
symptoms, others have diarrhea and other gastrointestinal problems.
Because B. hominis often appears with other organisms, experts aren't
sure whether B. hominis causes disease on its own.

It's possible that some people are susceptible to illness caused by B.
hominis infection, while others carry the parasite without signs or
symptoms.

Many types of protozoa get into the intestinal tract through oral-fecal
contact, such as occurs when a person doesn't wash his or her hands
thoroughly after using the toilet before preparing food. No one knows
for certain how B. hominis is transmitted, but experts suspect it's
through oral-fecal contact. Experts do know that the incidence of
infection associated with B. hominis increases in places with inadequate
sanitation and poor personal hygiene.

©1998-2010 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.
Expand Arrow DownRisk factors

Blastocystosis is common, and anyone can get the infection. You may be
at higher risk if you travel where sanitation is inadequate or where the
water may not be safe.

©1998-2010 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.
Expand Arrow DownComplications

If you have diarrhea associated with B. hominis, it's likely to be
self-limiting. However, anytime you have diarrhea, you lose vital
fluids, salts and minerals, which can lead to dehydration. Children are
especially vulnerable to dehydration.

©1998-2010 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.
Expand Arrow DownPreparing for your appointment

You're likely to start by first seeing your family doctor or a general
practitioner. However, in some cases when you call to set up an
appointment, you may be referred immediately to an infectious disease
specialist or a gastroenterologist.

Because appointments can be brief, it's a good idea to be well prepared
for your appointment. Here's some information to help you get ready for
your appointment, and what to expect from your doctor.

What you can do

* Be aware of any pre-appointment restrictions. At the time you make
the appointment, be sure to ask if there's anything you need to do in
advance, such as restrict your diet.
* Write down any symptoms you're experiencing, including any that
may seem unrelated to the reason for which you scheduled the
appointment.
* Write down key personal information, including any major stresses
or recent life changes. Let your doctor know if you've recently traveled
out of the country, especially if you traveled to a developing country.
* Make a list of all medications, as well as any vitamins or supplements, that you're taking.
* Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions
will help you make the most of your time together. List your questions
from most important to least important in case time runs out.

For blastocystis, some basic questions to ask your doctor include:

* What is likely causing my symptoms?
* Are there other possible causes for my symptoms?
* Do I need any tests?
* What treatment do you recommend?
* Are there alternatives to the approach you're suggesting?
* Are there any dietary restrictions I need to follow?
* Do I need to see a specialist?
* Is there a generic alternative to the medicine you're prescribing me?
* Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.

What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to
answer them may reserve time to go over any points you want to spend
more time on. Your doctor may ask:

* When did you first begin experiencing symptoms?
* Have your symptoms been continuous or occasional?
* How severe are your symptoms?
* What, if anything, seems to improve your symptoms?
* What, if anything, appears to worsen your symptoms?
* Have you traveled out of the country recently?
* Do you have any other health conditions?

What you can do in the meantime
If your symptoms are related to blastocystis, they may go away on their
own before you even see your doctor. Be sure to stay well hydrated in
the meantime. Oral rehydration solutions (ORS) — available through
drugstores and health agencies worldwide — can effectively replace lost
fluids and electrolytes.

If no oral rehydration solutions are available, you can make your own by
combining 1 quart (about 1 liter) of bottled or boiled water with 8
level teaspoons (about 40 milliliters) of table sugar and 1 level
teaspoon (about 5 milliliters) of table salt.

Anti-diarrheal medications aren't generally recommended, because they can make some diarrheal illnesses worse.

©1998-2010 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.
Expand Arrow DownTests and diagnosis

The cause of your diarrhea may be difficult to diagnose. Even if B.
hominis is present on a fecal exam, it may not be causing your symptoms.
Your doctor likely will take your medical history, ask you about recent
activities, such as traveling, and perform a physical exam. A number of
lab tests help diagnose parasitic diseases and other noninfectious
causes of gastrointestinal symptoms:

*

Stool (fecal) exam. Also called an ova and parasite test, this
test looks for parasites or their eggs (ova) that cause signs and
symptoms, such as diarrhea and abdominal cramping and bloating. Your
doctor may ask you for several stool samples, each from a different day.

Your doctor may give you a special container with preservative
fluid for your stool samples. If not, refrigerate your samples until you
take them to your doctor's office or the lab your doctor designates.
Don't freeze the samples.
* Endoscopy. If you have symptoms, but the fecal exam doesn't reveal
the cause, your doctor may request this test. A doctor, usually a
gastroenterologist, inserts a tube into your mouth or rectum to look for
the cause of your symptoms. You'll be sedated for this test, and you'll
need to fast beginning at midnight the night before the test.
* Blood tests. Although there are no blood tests that can detect B.
hominis, your doctor may order blood tests to look for other causes of
your signs and symptoms. That's because when your body is infected with a
parasite, your immune system tries to fight the infection, which leaves
antibodies or parasite antigens or both in your system. A lab can
detect some parasites by examining a sample of your blood for the
antibodies or antigens.
* Scans. Some parasitic diseases may cause swelling or scarring of
internal organs. Your doctor may request an X-ray, magnetic resonance
imaging (MRI) or a computerized tomography (CT) scan to detect the
swelling or scarring.

©1998-2010 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.
Expand Arrow DownTreatments and drugs

If you have blastocystis without signs or symptoms, then you don't need
treatment. Mild signs and symptoms may improve on their own within a few
days.

Potential medications for treating blastocystis include the antibiotic
metronidazole (Flagyl), the combination medication sulfamethoxazole and
trimethoprim (Bactrim, Septra, others), and the antiprotozoal medication
iodoquinol (Yodoxin, others). However, keep in mind that response to
medication for B. hominis infection varies greatly from person to
person. And, because the symptoms you're having might be unrelated to
blastocystis, it's also possible that any improvement may be due to the
medication's effect on another organism.

©1998-2010 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.
Expand Arrow DownPrevention

You may be able to prevent blastocystis or other gastrointestinal
infection by taking a number of precautions while traveling in high-risk
countries.

Watch what you eat
The general rule of thumb is this: If you can't boil it, cook it or peel
it — forget it. Unfortunately, most travelers don't stick to these
guidelines all of the time. Remember these tips:

* Don't buy food from street vendors.
* Avoid unpasteurized milk and dairy products, including ice cream.
* Avoid raw or undercooked meat, fish and shellfish.
* Steer clear of moist food at room temperature, such as sauces and buffet offerings.
* Eat foods that are well cooked and served hot.
* Munch on dry foods — like breads — and foods high in sugar, such as jellies and syrups.
* Stick to fruits and vegetables that you can peel yourself, such as
bananas, oranges and avocados. Stay away from salads and unpeelable
fruits, such as grapes and berries.

Don't drink the water
When visiting high-risk countries, keep the following tips in mind:

* Avoid unsterilized water — from tap, well or stream. If you need
to consume local water, boil it for at least three minutes and then let
it cool to room temperature.
* Avoid ice cubes or fruit juices made with tap water.
* Beware of sliced fruit that may have been washed in contaminated water.
* Don't swim in water that may be contaminated.
* Keep your mouth closed while showering.
* Feel free to drink canned or bottled drinks in their original
containers — including water, carbonated beverages, beer or wine — as
long as you break the seals on the containers yourself. Wipe off any can
or bottle before drinking or pouring.
* Use bottled water to brush your teeth.
* Use bottled or boiled water to mix baby formula.
* Make sure hot beverages, such as coffee or tea, are steaming hot.

If it's not possible to buy bottled water or boil your water, bring some
means to purify water: Consider a water-filter pump with a
microstrainer filter that can filter out small microorganisms. Look in
camping stores for a filter that is certified by the National Science
Foundation.

Another approach is to chemically disinfect water with iodine or
chlorine. Iodine tends to be more effective, but reserve it for short
trips, because too much iodine can be harmful to your body. You can
purchase iodine tablets or crystals at camping stores and pharmacies. Be
sure to carefully follow the directions.

Take precautions against passing a parasite to others
If you have blastocystis or another gastrointestinal infection, good
personal hygiene will help keep you from spreading the infection to
others:

* Wash hands with soap and water frequently, especially after using
the toilet and before handling food. Rub soapy, wet hands together for
at least 15 seconds before rinsing. If soap and water aren't available,
use an alcohol-based hand sanitizer.
* Wash hands well after changing a diaper, especially if you work in a child care center, even if you wear gloves.
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