Severe Colitis with Portal Venous Gas Caused by <i>Brachyspira pilosicoli</i> Infection

Abstract

We herein report a case of Brachyspira pilosicoli-caused severe colitis presenting with portal venous gas. A 75-year-old man was admitted because of a fever, severe abdominal pain and bloody diarrhea. He was negative for anti-HIV antibodies. He had been in close contact with a dog earlier. Abdominal computed tomography detected severe wall-thickening and fat-stranding of the entire colon accompanied by portal venous gas. A smear examination of his stool showed many Gram-negative spiral rods, suggesting intestinal spirochetosis. A polymerase chain reaction assay using stool samples detected an amplified band specific for B. pilosicoli. He responded well to antimicrobial agents including metronidazole.

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

“…in humans are asymptomatic. However, spirochetes have exhibited a spectrum of pathogenesis which ranges from asymptomatic [8][9][10] to spirochetemia in critically ill patients (mostly by B. pilosicoli). 8,[11][12][13] In some studies, the association between B. aalborgi colonization and gastrointestinal problems remains unclear.…”

“…However, spirochetes have exhibited a spectrum of pathogenesis which ranges from asymptomatic [8][9][10] to spirochetemia in critically ill patients (mostly by B. pilosicoli). 8,[11][12][13] In some studies, the association between B. aalborgi colonization and gastrointestinal problems remains unclear. 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.…”

Clinical and Pathologic Factors Associated With Colonic Spirochete (Brachyspira pilosicoli and Brachyspira aalborgi) Infection: A Comprehensive Systematic Review and Pooled Analysis

“…B pilosicoli causes diarrhea in pigs, and our data suggest that diarrhea is the predominant GI symptom in this pooled human cohort. 1 , 33 Pyrexia was also identified as an important clinical factor of B pilosicoli infection. B pilosicoli infection was less likely to be found in the rectum, which may be related to the mechanism by which this species attaches itself to the mucosal epithelium.…”