I have been diagnosed with this protozoa. My questions are: Does having had malaria 20 yrs ago have anything to do with this? Is this contagious to my family, if so should they have stool test run? Can this become systemic? I have also been diagnosed with rhumatoid arthritis, can these be somehow triggered by each other? Will this illness recur or be cured?
REPLY:
This unicellular protozoan is worldwide in distribution. Transmission is believed to be from infected well water contaminated by sewage. Most individuals with this organism in their stools are free of symptoms and the parasite can become undetectable in many of these individuals without any treatment at all. It is not at all clear whether disease in humans is caused by this parasite. In those individuals who have symptoms of diarrhea or intestinal upset most authorities suggest that patients are thoroughly studied for other causes for these symptoms before treatment is directed at B. hominis. Both metronidazole and iodoquinol have been used to treat this organism. Even in individuals with immunodeficiency and in others with inflammatory bowel disease the medical literature is undecided on whether the presence of this organism in the stool is in any way related to diarrhea or other symptoms.
I don't believe there is any obvious association with your previous malaria or current problems with rheumatoid arthritis. Since the spread of this organism is thought to be fecal-oral you probably do not pose a risk to your family especially if you routinely observe good hand washing habits before meal preparation and after using the bathroom. Nevertheless you may wish to have other family members' stools checked since you may all have been exposed to this organism at the same time.
The chance of having systemic symptoms is probably very low if not zero. Indeed if you are not having any symptoms at all it might be best to see if this organism will disappear spontaneously from your stools. You might have your stools re-examined in four to six weeks.
You may want to discuss repeat stool tests and other aspects of this problem with your doctor.
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Bruce Sckolnick, M.D.
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