Blastocystis spp. Beyond the Gut: Mechanisms of Extraintestinal Dissemination and Cross-Species Clinical Implications

Dear Colleagues,

Although Blastocystis is primarily recognized as an intestinal protist, emerging evidence suggests that its clinical significance may extend far beyond gastrointestinal health. Despite being one of the most prevalent eukaryotic microorganisms in the human gut, underappreciation and gaps in knowledge persist among medical professionals regarding Blastocystis’s status as a true pathogen, with this gap extending to other aspects of extraintestinal relevance. Key underappreciated features include, but are not limited to, (i) the potential diversity of extraintestinal sites where Blastocystis may disseminate, (ii) the mechanisms enabling translocation from the intestinal lumen to sterile body compartments, (iii) the strain-specific pathogenic potential and cross-species transmission patterns, and (iv) the clinical and economic implications of extraintestinal dissemination in both immunocompetent and -compromised hosts.

While the medical community often focuses on well-characterized parasitic infections, Blastocystis extraintestinal dissemination represents an increasingly important yet underappreciated potential problem. The global prevalence of intestinal Blastocystis colonization ranges from 30% to over 60% in some populations, yet the incidence, associated morbidity, and healthcare costs of potential extraintestinal manifestations remain largely unexplored. Understanding the molecular mechanisms of dissemination, host–parasite interactions beyond the gut, and the clinical spectrum of extraintestinal disease is crucial for developing evidence-based diagnostic criteria, treatment protocols, and prevention measures.

This Special Issue aims to bring together original research and comprehensive reviews addressing the mechanisms of Blastocystis extraintestinal dissemination, clinical case reports, cross-species comparative studies, immunological responses, and the potential medical and economic burden of these infections. We welcome submissions exploring novel diagnostic approaches, therapeutic strategies, and epidemiological data that will enhance our understanding of this neglected aspect of Blastocystis pathobiology.

Dr. Arony Martinez
Dr. Pablo Maravilla
Guest Editors

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