The Medical clinics of North America . w the boy and concurred in thediagnosis of acute appendicitis. Operation was refused and aslow recovery took place. In two years there has been no re-currence and no gastro-intestinal symptoms other than occasionalconstipation. The case here presented can remain simply as an instance ofacute appendicitis associated with the presence of balantidia inthe stools. There was no previous significant history. Therewas no earlier association or contact with pigs. Operation wasrefused, the patient regained normal health, and has kept itfor the last two years. It i
The Medical clinics of North America . w the boy and concurred in thediagnosis of acute appendicitis. Operation was refused and aslow recovery took place. In two years there has been no re-currence and no gastro-intestinal symptoms other than occasionalconstipation. The case here presented can remain simply as an instance ofacute appendicitis associated with the presence of balantidia inthe stools. There was no previous significant history. Therewas no earlier association or contact with pigs. Operation wasrefused, the patient regained normal health, and has kept itfor the last two years. It is impossible to say definitely that the 396 ALFRED C. REED, HARRY A. WYCKOFF balantidium was responsible for the inflamed appendix. It cer-tainly is not possible to say that the balantidium was harmlessin this respect. We will next present very briefly a single case of infectionwith CHILOMASTRIX MESNILIMacrostoma Mesnili) In shape this flagellate resembles an elongated top. Thereare three active flagella projecting from the blunt Fig. 92.—Chilomastrix mesnili. Vegetative and encysted forms. Seen in the stool its more remarkable characteristics are itsrather active progression, accompanied by rotation about thelong axis; a prominent longitudinal slit on one surface, in thefloor of which is the mouth; a usually well-defined spiral grooverunning about the body from mouth to tail, and, sometimes, itsspotted cytoplasm. INTESTINAL PROTOZOA IN CLINICAL PRACTICE 397 The organism forms small oval cysts with a blister-likeprominence at one end. In stained specimens the remains ofthe mouth groove may be seen, and to one side of this a lessevident globular nucleus. Cysts probably remain viable forsome time in moist feces, thus providing a source of infection. Case II.—A. A. G. A man of sixty-four years, a retiredrancher, had suffered for two years from a classical picture ofpernicious anemia. He had been under the care of variouscompetent internists. His condition had been exhaus
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