Abstract
Blastocystis is a noninvasive, luminal parasite commonly reported in human stool samples. Its clinical presentation is diverse ranging between acute diarrhea and mild chronic abdominal discomfort. Clinical manifestations of Blastocystis also include urticaria and irritable bowel syndrome. Similar to other luminal parasites such as Giardia and Entamoeba, asymptomatic carriage of Blastocystis is common. The parasite is zoonotic and animal contact often leads to infections. The Blastocystis is also opportunistic with higher frequency in immunocompromised populations including pediatric and cancer patients as well as HIV-infected individuals. Although parasite is noninvasive it might complicate pathogenicity of other invasive pathogens. Metronidazole is the treatment of choice, but clinical management of Blastocystis is difficult owing to frequent reports of treatment failure. It also exhibits extensive phenotypic and genotypic diversity, not efficiently captured by classical diagnostic techniques, leading to under-reporting of Blastocystis infections. Diversity in pathobiology between variant parasite subtypes is suspected to be responsible for diverse clinical presentations of Blastocystis infections. Treatment outcomes are also suspected to be dependent on parasite subtype and phenotype. Despite a number of controversies surrounding the pathogenic potential of Blastocystis, several advances have been made in recent years in the areas of parasite virulence as well as molecular and cellular biology. These advances have also fueled improvements in clinical diagnostic tools as well identification of novel treatment options. This chapter highlights some of these recent developments.
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Mirza, H., Tan, K.S.W. (2012). Clinical Aspects of Blastocystis Infections: Advancements Amidst Controversies. In: Mehlhorn, H., Tan, K., Yoshikawa, H. (eds) Blastocystis: Pathogen or Passenger?. Parasitology Research Monographs, vol 4. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-32738-4_5
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