Blastocystis hominis
From IDWiki
Background
Epidemiology
- Worldwide, but varies by subtype
- Subtype 3 most common worldwide in human
- Subtype 4 is in Europe
- Prevalence higher in developing than developed countries
Clinical Presentation
- Unclear if it causes a clinical syndrome; may be strain-dependent
- Has been implicated in acute diarrhea, chronic diarrhea, bloating, flatulence, abdominal cramping, and fatigue, as well as irritable bowel syndrome
Diagnosis
- Stool microscopy with trichrome stain
- In vitro cell culture
- PCR is standard
Management
- Eliminate all other causes of symptoms
- If still symptomatic, can consider treatment
- Nitazoxanide 500 mg po bid for 3 days
- Can also try: metronidazole 750 mg po tid for 10 days, trimethoprim-sulfamethoxazole DS 1 tab po bid for 7 days, and iodoquinol 650 mg po tid for 20 days
- Unclear which, if any, is helpful
References
- ^ Elisa Piperni, Long H. Nguyen, Paolo Manghi, Hanseul Kim, Edoardo Pasolli, Sergio Andreu-Sánchez, Alberto Arrè, Kate M. Bermingham, Aitor Blanco-Míguez, Serena Manara, Mireia Valles-Colomer, Elco Bakker, Fabio Busonero, Richard Davies, Edoardo Fiorillo, Francesca Giordano, George Hadjigeorgiou, Emily R. Leeming, Monia Lobina, Marco Masala, Andrea Maschio, Lauren J. McIver, Mauro Pala, Maristella Pitzalis, Jonathan Wolf, Jingyuan Fu, Alexandra Zhernakova, Simone M. Cacciò, Francesco Cucca, Sarah E. Berry, Danilo Ercolini, Andrew T. Chan, Curtis Huttenhower, Tim D. Spector, Nicola Segata, Francesco Asnicar. Intestinal Blastocystis is linked to healthier diets and more favorable cardiometabolic outcomes in 56,989 individuals from 32 countries. Cell. 2024;187(17):4554-4570.e18. doi:10.1016/j.cell.2024.06.018.
