Intestinal Spirochetosis and Acquired Immunodeficiency Syndrome: Ultrastructural Studies of Two Cases

Guccion, John G.; Benator, Debra; Zeller, Jack A.; Termanini, B; Saini, Nirmal

doi:10.3109/01913129509014599

Cited by 42 publications

(63 citation statements)

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“…On the other hand, B. aalborgi was found in rural patients with gastrointestinal symptoms in whom no other pathogenic microorganisms were detected. A similar situation has been reported in other investigations [3,26,27]. It is possible that different strains or ' groups ' [20] of B. aalborgi may vary in their virulence, or that the extent or site of colonization may influence the clinical outcome.…”

Section: Discussionsupporting

confidence: 81%

Comparison of prevalence and risk factors for faecal carriage of the intestinal spirochaetes Brachyspira aalborgi and Brachyspira pilosicoli in four Australian populations

2005

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SUMMARYThis study examined the prevalence of the intestinal spirochaetes Brachyspira aalborgi and Brachyspira pilosicoli in different Western Australian (WA) populations. Faecal samples included 287 from rural patients with gastrointestinal symptoms, comprising 142 from non-Aboriginal and 145 from Aboriginal people ; 227 from recent healthy migrants to WA from developing countries; and 90 from healthy non-Aboriginal individuals living in Perth, WA. DNA was extracted from faeces, and subjected to PCR assays for both species. B. pilosicoli-positive individuals were confined to the rural Aboriginal (14 . 5 %) and migrant (15 . 0%) groups. B. aalborgi was detected at a lower but similar prevalence in all four groups: rural non-Aboriginals, 5 . 6% ; rural Aboriginals, 6 . 9% ; migrants, 7 . 9% ; controls, 5 . 6 %. In migrants and Aborigines, the presence of B. pilosicoli and B. aalborgi was associated (P<0 . 001), suggesting that colonization by B. pilosicoli may be facilitated by colonization with B. aalborgi. Amongst the Aboriginal patients, logistic regression identified both spirochaete species as being associated with chronic diarrhoea, failure to thrive and being underweight. Both species may have pathogenic potential, but B. aalborgi appears more host-adapted than the opportunistic B. pilosicoli.

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Section: Discussionsupporting

confidence: 81%

Comparison of prevalence and risk factors for faecal carriage of the intestinal spirochaetes Brachyspira aalborgi and Brachyspira pilosicoli in four Australian populations

2005

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“…There have been some reports of invasive human intestinal spirochetosis in HIV-positive patients, however, even in such cases, the number of invasive spirochetes was quite small compared with those on the surface epithelium. 18 Thus, in our case, failure to detect invasive spirochetes might be due to inappropriate portion of sectioning and these clinical symptoms might be attributed to spirochetal infection especially by B. pilocicoli spirochete, because no other possible enteropathogenic organism was characterized neither by culture nor immunostaining, and these symptoms were eliminated by antibiotic therapy.…”

Section: Discussionmentioning

confidence: 68%

“…However, recent studies have demonstrated invasive spirochetes penetrating into epithelial cells, lamina propria, macrophages, and even Schwann cells. [17][18][19] Furthermore, marked increase of IgE-producing plasma cells in lamina propria and intraepithelial mast cells has been reported, suggesting close association of immediate-type immune reaction of the host. 20 Kö rner et al 21 postulate that invasive human intestinal spirochetosis with marked inflammatory reaction is related to clinical symptoms.…”

Section: Discussionmentioning

confidence: 99%

Human intestinal spirochetosis in Japan; its incidence, clinicopathologic features, and genotypic identification

et al. 2008

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Human intestinal spirochetosis is a common condition in Western countries, but is not well recognized in Japan. To demonstrate the incidence and clinicopathologic findings of human intestinal spirochetosis in Japan, we retrospectively investigated biopsy, and endoscopically or surgically resected specimens of the large intestine. Among a series of 2556 samples, 11 cases of human intestinal spirochetosis were detected (0.4%). Together with additional nine cases sporadically found, 20 cases of human intestinal spirochetosis were subjected to molecular detection of two strains of spirochetes (Brachyspira aalborgi and Brachyspira pilosicoli) by amplifying species-specific portion of 16S ribosomal RNA and NADH oxydase gene by polymerase chain reaction. B. aalborgi was detected in all cases examined, three of which revealed dual infection of both species. Our results suggest that human intestinal spirochetosis infection is relatively rare, and B. aalborgi is the most prevalent species in Japan. Most of human intestinal spirochetosis were asymptomatic, although symptomatic in exceptional cases. In addition, we emphasize a usefulness of immunostaining with anti-Treponema pallidum and anti-Mycobacterium bovis polyclonal antibodies for detecting the spirochetes.

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“…Interestingly, other spirochetes, including Treponema pallidum, Leptospira species, and some Borrelia species, also may show trophism toward neuronal tissue. In another study, spirochetal invasion was observed in two HIV ϩ patients where there was an extension of IS into the crypts of Lieberkühn, with spirochetal invasion of the colonic mucosa, and a marked inflammatory response that involved macrophages in the underlying lamina propria (127). Spirochetes that are presumed to have been B. pilosicoli also have been observed in the livers of immunocompromised human patients who had invasive colitis (128).…”

Section: Observations In Natural and Experimental Infectionsmentioning

confidence: 95%

The Spirochete Brachyspira pilosicoli, Enteric Pathogen of Animals and Humans

Hampson

2018

Clin Microbiol Rev

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SUMMARY Brachyspira pilosicoli is a slow-growing anaerobic spirochete that colonizes the large intestine. Colonization occurs commonly in pigs and adult chickens, causing colitis/typhlitis, diarrhea, poor growth rates, and reduced production. Colonization of humans also is common in some populations (individuals living in village and peri-urban settings in developing countries, recent immigrants from developing countries, homosexual males, and HIV-positive patients), but the spirochete rarely is investigated as a potential human enteric pathogen. In part this is due to its slow growth and specialized growth requirements, meaning that it is not detectable in human fecal samples using routine diagnostic methods. Nevertheless, it has been identified histologically attached to the colon and rectum in patients with conditions such as chronic diarrhea, rectal bleeding, and/or nonspecific abdominal discomfort, and one survey of Australian Aboriginal children showed that colonization was significantly associated with failure to thrive. B. pilosicoli has been detected in the bloodstream of elderly patients or individuals with chronic conditions such as alcoholism and malignancies. This review describes the spirochete and associated diseases. It aims to encourage clinicians and clinical microbiologists to consider B. pilosicoli in their differential diagnoses and to develop and use appropriate diagnostic protocols to identify the spirochete in clinical specimens.

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Intestinal Spirochetosis and Acquired Immunodeficiency Syndrome: Ultrastructural Studies of Two Cases

Cited by 42 publications

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Comparison of prevalence and risk factors for faecal carriage of the intestinal spirochaetes Brachyspira aalborgi and Brachyspira pilosicoli in four Australian populations

Comparison of prevalence and risk factors for faecal carriage of the intestinal spirochaetes Brachyspira aalborgi and Brachyspira pilosicoli in four Australian populations

Human intestinal spirochetosis in Japan; its incidence, clinicopathologic features, and genotypic identification

The Spirochete Brachyspira pilosicoli, Enteric Pathogen of Animals and Humans

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