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Factors that influence the shedding of Blastocystis cysts in an irritable bowel syndrome (IBS) patient—an evidence-based case study

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Abstract

Blastocystis is one of the most common gut parasites found in the intestinal tract of humans and animals. We have previously reported the irregular shedding of Blastocystis cysts in stools from infected patients. In the present study, we assess the factors influencing shedding patterns from a Blastocystis ST3-infected IBS patient. The stools samples were voluntarily submitted for examination for a period of 30 days from Blastocystis ST3-infected IBS patient. A questionnaire on the factors that could influence the shedding pattern of the cysts was designed to assess the following information: (a) the frequency of frequenting the toilet in a day, (b) the timing of frequenting the toilet, (c) the stool forms, (d) the type of mood the patient was in when frequenting the toilet and (e) food intake. A total of 79 stool samples were collected for 30 days. The highest number of cysts recorded when the patient visited the toilet three times a day was 22.2 × 106 cysts/g. Frequenting the toilet between 6 a.m. to 11.59 a.m. showed the highest number of cysts, i.e. 21.7 × 106 cysts/g. Semi-solid forms showed the highest cyst count, i.e. 2.00 × 106 cysts/g. Irregular shedding of cysts was seen in 10 out of 30 days where the widest range recorded on day 17 was between 0 to 1.2 × 106 cysts/g. The average daily cyst count on days of emotional fluctuations was from 0 to 5.13 × 106 cysts/g. In conclusion, the study confirms that there are factors influencing shedding patterns of Blastocystis, and these have important implications when it comes to diagnosis and transmission of the parasite.

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Acknowledgments

The study would not have been possible without the support of HIR grant UM.C/625/1/HIR/044 and Postgraduate Research Grant (PPP) PG108-2012B. We would like to also thank the patient who was willing to provide her stool samples for an entire of 30 days.

Conflict of interest

The authors have no conflict of interest. The authors do not have a commercial or other association that has a conflict of interest.

Authors’ contribution

NDR, SKG, TTC and SM was involved in all stages of study, including conceived and designing the experiment, data collection and analysis, interpretation of results. NDR was responsible for the write-up of the manuscript, and all authors read and approved the finalised manuscript.

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Authors and Affiliations

  1. Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia

    Nanthiney Devi Ragavan, Suresh Kumar Govind & Tan Tian Chye

  2. Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia

    Sanjiv Mahadeva

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  1. Nanthiney Devi Ragavan
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  2. Suresh Kumar Govind
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  3. Tan Tian Chye
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  4. Sanjiv Mahadeva
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Correspondence to Suresh Kumar Govind.

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Ragavan, N.D., Govind, S.K., Chye, T.T. et al. Factors that influence the shedding of Blastocystis cysts in an irritable bowel syndrome (IBS) patient—an evidence-based case study. Parasitol Res 114, 2999–3005 (2015). https://doi.org/10.1007/s00436-015-4502-3

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