DOI: 10.36347/sajb.2018.v06i01.001

Pages: 1-4

Balantidium coli, a ciliated protozoan parasite that infects primates and pigs, and is the largest protozoan to infect humans, is a well-known cause of diarrhea and dysentery in humans. Extra-intestinal infections have rarely been reported. We report a case of extra-intestinal involvement, with secondary spontaneous pneumothorax in a 32-year-old man of rural background, tractor driver by occupation, chronic alcoholic & chronic bidi smoker. Diagnosis was made by wet mount of pleural fluid which showed actively motile numerous trophozoites with classical rotatory boring motility compatible with Balantidium coli with a background of very few acute inflammatory cells. The origin of infection was not clear, but inhalation of rodent manure was postulated as there was no history of intestinal disease. The patient was treated with Tetracycline and Metronidazole with dramatic improvement within 48 hours & complete cure within 10days. Balantidium coli infection should be considered as part of the Differential diagnosis of haemoptysis & pulmonary hemorrhage especially in patients with cavitary lung involvement who have contact with the pig industry.