The description is classic for Balantidium coli: large (visible on low power), ciliated, and motile trophozoites in dysenteric stool. The first-line treatment for symptomatic balantidiasis is tetracycline. Tetracyclines are effective and widely used. Metronidazole is also effective and is often listed as an alternative, but tetracycline is traditionally considered the drug of choice. Praziquantel is for trematodes and cestodes. Chloroquine is for malaria and extraintestinal amebiasis (liver abscess), not for intestinal protozoa. Therefore, in this scenario, tetracycline is the most appropriate initial choice.

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Zambia

• Joseph Soko – 101 pts

• Visual Pathway Lesions
• Positive and Negative Symptoms
• Hallucinations and Delusions
• Antipsychotic Medications
• Emergency: Environmental Emergencies