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Published on: May 2, 2018
[Severe diarrhoea with invasive intestinal spirochaetosis]
N G Koopmans1, W S Kwee, W Grave
1Universiteit Maastricht, Faculteit der Geneeskunde, Maastricht.
Nederlands Tijdschrift Voor Geneeskunde
|January 10, 2006
Summary
Severe diarrhea in a 38-year-old male was linked to invasive intestinal spirochetosis, specifically Brachyspira aalborgi. Treatment with clindamycin resolved the symptoms, suggesting a causal role for this infection.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Invasive intestinal spirochetosis (IIS) is a condition often discovered incidentally during colon biopsy analysis.
- The direct causal link between IIS and chronic diarrhea remains debated in medical literature.
Observation:
- A 38-year-old male presented with a prolonged history of severe diarrhea.
- Initial investigations, including fecal cultures and parasitological exams, were negative.
- Colonoscopy revealed normal mucosa, but biopsies showed invasive spirochetes, identified as Brachyspira aalborgi via 16S rDNA sequencing.
Findings:
- Histological examination confirmed invasive intestinal spirochetosis.
- Immunostaining showed cross-reactivity with Borrelia burgdorferi.
- Successful treatment of severe diarrhea was achieved with clindamycin after metronidazole failed.
Implications:
- This case supports a potential causal relationship between Brachyspira aalborgi infection and severe gastrointestinal symptoms.
- The findings highlight the importance of considering IIS in cases of unexplained chronic diarrhea.
- Effective antibiotic treatment may be beneficial for patients with symptomatic invasive intestinal spirochetosis.
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