Espiroquetosis intestinal humana: serie clínica y revisión de la literatura

Human intestinal spirochetosis, a sexually transmissible infection? Review of six cases from two sexually transmitted infection centres in Barcelona

“…1 In humans, it has been associated with two spirochete species, Brachyspira pilosicoli (mostly in an asymptomatic way, but sometimes as an opportunistic pathogen) and Brachyspira aalborgi (which can be pathogenic in humans more often than B. pilosicoli); both species belong to the family Brachyspiraceae. [2][3][4][5][6][7] Brachyspira pilosicoli may also be pathogenic in poultry and pigs. Most of the cases of intestinal colonization by spirochetal spp.…”

“…14,15 Thorrell et al 16 performed culture and whole-genome sequencing of the bacterial isolates in 17 patients with spirochetosis on biopsy, showing the predominance of B. aalborgi compared to B. pilosicoli. The prevalence of HIS varies depending on the country, being higher in developing countries, 2,3,[5][6][7]17 probably due to the transmission by ingestion of untreated water. 6 In Europe, there is an estimated prevalence of between 2.5 and 9%.…”

“…The prevalence of HIS varies depending on the country, being higher in developing countries, 2,3,[5][6][7]17 probably due to the transmission by ingestion of untreated water. 6 In Europe, there is an estimated prevalence of between 2.5 and 9%. 2,4,17,18 The mechanism of transmission is unknown; however, the fact that it has been associated with gonococcal and/or Shigella flexneri coinfection in some cases 5,6 could mean that the sexual transmission route is possible, probably by oro-anal sexual practices, 19 especially in developed countries.…”

“…6 In Europe, there is an estimated prevalence of between 2.5 and 9%. 2,4,17,18 The mechanism of transmission is unknown; however, the fact that it has been associated with gonococcal and/or Shigella flexneri coinfection in some cases 5,6 could mean that the sexual transmission route is possible, probably by oro-anal sexual practices, 19 especially in developed countries. The higher frequency in men who have sex with men (MSM) and in people living with HIV (PLHIV) reinforces this possible hypothesis.…”

“…2,4,6,17,[19][20][21][22] According to pathophysiology, Brachyspiras have a slow growth as opportunistic anaerobes in humans and they have a cytopathic effect with flattening and destruction of microvilli and induction of changes in the cellular cytoskeleton. 5,6 The development of diarrhoeal disease in pigs may be caused by Brachyspira hyodysenteriae and Brachyspira hampsonii, as a result of the inhibition of the transcription and translation of Na þ /K þ exchanger 3. 23 This is the reason why, persistent chronic diarrhoea (for more than 4 weeks) is the most common clinical presentation of HIS, when it is symptomatic.…”