A Case of Human Intestinal Spirochetosis Diagnosed During Screening Colonoscopy

Alnimer, Lynna; Zakaria, Ali; Warren, Bradley

doi:10.7759/cureus.14829

Cited by 5 publications

(13 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the United States, homosexual males have the highest prevalence overall, with a colonization rate of 62.5%. Although researchers have tried to make a connection regarding sexual transmission, none has been identified [ 3 ]. Heterosexual adults in multiple countries, including the United States, Italy, and France, have also been noted to contract the disease.…”

Section: Discussionmentioning

confidence: 99%

“…Other reported symptoms can include one or all of the following: constipation, abdominal pain, hematochezia, and alternating between constipation and diarrhea. Watery diarrhea is thought to be a sequela of the spirochetes destroying the colonic microvilli resulting in the loss of absorptive area [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…The surface of the colonic epithelium shows blue fringes in a palisade-like arrangement that are characteristic. Electron microscopy shows the spirochetes embedded into the individual colon cells, docking themselves into the cell membrane between destroyed microvilli [ 3 ]. Essentially, the villi of the epithelium become blunted from the spirochetes and the mitochondria of cells swell and develop glycocalyx defects.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, PCR has been used to amplify rRNA and detect B. pilosicoli from colonic feces. Fluorescent in-situ hybridization with oligonucleotide can target the rRNA of the spirochete species as well [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…This prescription normally accounts for successful treatment and eradication of the spirochetes, as seen in our patient. However, if there is no improvement, a course of macrolides and clindamycin can be considered [ 3 ]. There is no need for patients to undergo further monitoring or screening once their symptoms have resolved.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Intestinal Spirochetes Associated With Asymptomatic COVID-19 Infection

Houtte¹,

Perrotti²,

Gade³

et al. 2022

Cureus

View full text Add to dashboard Cite

A 60-year-old, human immunodeficiency virus (HIV)-negative, homosexual male presented to our colorectal clinic with abdominal pain for three weeks followed by persistent watery diarrhea refractory to loperamide. He had no history of recent travel, no known infectious contacts, and his last colonoscopy nine years prior was within normal limits. After one episode of hematochezia, computed tomography of the abdomen/pelvis was performed demonstrating colitis and coronavirus disease 2019 (COVID-19)-related changes to the lung bases. Testing confirmed COVID-19 infection which was self-limited. The initial workup for infectious colitis was negative. Colonoscopy revealed no evidence of gross colitis. Histopathology demonstrated microscopic colitis with spirochete colonization of the intestinal epithelium. A course of metronidazole led to the resolution of the patient's symptoms.Intestinal spirochetosis has been described as a rare source of colitis caused by the organism Brachyspira pilosicoli in an immunocompromised population (HIV-positive, organ transplant). It is associated with abdominal pain and refractory diarrhea. This report details the unique case of intestinal spirochetosis in an HIV-negative, COVID-19-positive patient with no other risk factors for immunosuppression. Further review is necessary to establish a true association; however, this case suggests that intestinal spirochetosis should be considered during the workup of chronic diarrhea (more than two weeks) in COVID-19-positive patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Intestinal Spirochetes Associated With Asymptomatic COVID-19 Infection

Houtte¹,

Perrotti²,

Gade³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

Spirochetosis Mimicking Acute Appendicitis: Clinical Report and Review of the Literature

Lüthy,

Käser,

Wagener

et al. 2023

Inflamm Intest Dis

View full text Add to dashboard Cite

Introduction: Intestinal spirochetosis is sometimes found by chance in histological specimen of routine endoscopies. There are only a few cases described in the literature that spirochetosis of the appendix was mimicking acute appendicitis. We present a case of pseudoappendicitis with the histological finding of spirochetes and review the current literature. Case Presentation: A 72-year-old woman presented with pain of the lower right abdomen and previous systemic corticoid therapy. In clinical examination, there was a tenderness and pain in the right lower quadrant, and inflammation values were elevated. An abdominal computed tomography scan revealed no obvious inflammation of the appendix. A diagnostic laparoscopy was performed and revealed a macroscopically uninflamed appendix which was removed. Histology revealed spirochetosis of the appendix but no typical signs of appendicitis. The patient was treated with antibiotics for 5 days and was discharged without abdominal pain. In a clinical control 6 weeks later, the abdominal pain had disappeared and the patient was in good clinical condition. Discussion: Intestinal spirochetosis is randomly found in histological specimen during routine endoscopies, even in asymptomatic patients. There are only a few cases described with spirochetosis of the appendix causing pain and mimicking appendicitis; hence, this entity is an important differential diagnosis of pain in the right lower quadrant of the abdomen.

show abstract