From: Update on the pathogenic potential and treatment options for Blastocystis sp
Patient | Clinical history | Diagnosis | Treatment | Outcome | Study |
---|---|---|---|---|---|
One 11 y.o male and one 12 y.o male | Both presented with right lower quadrant tenderness, anorexia, abdominal pain, nausea, vomiting | Initially diagnosed with appendicitis. Stool examination showed Blastocystis and patients were then diagnosed with Blastocystis infection | Metronidazole and co-trimoxazole | Complete recovery | [15] |
24 y.o female | Nine week history of urticaria, hives, chronic diarrhoea, IBS | Initially diagnosed with cellulitis. Treated with non-steroidal cream with no recovery of symptoms. Presented with hives and diagnosed as urticaria. Extensive investigation showed 4 + Blastocystis in her stool. | Metronidazole | All urticarial and IBS symptoms cleared | [24] |
45 y.o female | Four month history of erythematous and pruriginous lesions on trunk and limbs, mild gastoenteric complaints | Diagnosed with urticaria. Extensive investigation showed the stool postive for Blastoycstis. | Paromomycin and metronidazole | All urticarial and gastrointestinal symproms cleared | [25] |
32 y.o female | Four year history of allegic rhinitis and chronic urticaria, swelling in pressure sites | Diagnosed with delayed pressure urticaria. Treated with systemic corticosteroids with only partial clearance of symptoms. Stool examination positive for Blastocystis | Metronidazole | All urticarial symptoms cleared | [26] |
60 y.o female | Four year history of anaphylactoid reactions, severe asthma and generalised urticaria | Diagnosed with chronic urticaria. Extensive investigation identified Blastocystis in the stool | Paromomycin | All urticaria symptoms cleared | [27] |
74 y.o male | Diarrhoea, abdominal pain, nausea, fatigue and fever | Hospitalised. Stool were positive for Blastocystis | Metronidazole | Clearence of symptoms after 10days | [18] |
29 y.o female | Six month history of morning stiffness, pain and swelling of joints, elbows, ankles, knees, diarrhoea, abdominal pain and vomiting | Treated for presumed infectious arthritis of the knee. No improvement. Microscopy of the synovial fluid and stools both showed the presence of Blastocystis. | Metronidazole | After two weeks knee inflammation subsided and all abdominal pain and diarrhoea were cleared | [28] |
24 y.o male | Six week history of diffuse abdominal pain and diarrhoea | Stool examination was positive for Blastocystis and Endolimax nana. | Metronidazole | Complete resolution of symptoms 10days later | [29] |
19 y.o male | Three week history of hives, abdominal pain for 2.5months | Diagnosed with acute urticaria. Routine testing showed the presence of Blastocystis in the stool ST3 | Metronidazole | 10days after treatment both urticaria and abdominal discomfort were cleared | [21] |
20 y.o male | Urticaria and flatulence | Treated with antihistamines with no success. Further investigation showed Blastocystis ST2 in the stool. Initially treated with metronidazole but treatment failure appears to have occured. Then treated with co-trimoxazole with no success and finally treated with combination metronidazole and paramomycin | Metronidazole then co-trimoxazole followed by paromomycin | All symptoms cleared 10Â days later | [22] |
40 y.o female | Hospitalised due to severe diarrhoea and fever | Blastocystis ST8 infection diagnosed from stool cultures. Treated with metronidazole. Symptoms persisted and the patient also noted bloating, flatulence and abdominal pain. Further treated with co-trimoxazole | Metronidazole then co-trimoxazole | All symptoms cleared | [30] |