Human intestinal spirochetosis--a review

Area of Science:

• Microbiology
• Gastroenterology
• Epidemiology

Background:

• Human intestinal spirochetosis (IS) is characterized by spirochetes on colorectal epithelium.
• Brachyspira aalborgi and Brachyspira pilosicoli are the main species in humans.
• IS prevalence is inversely related to living standards, higher in underdeveloped regions.

Purpose of the Study:

• To review the clinical significance of intestinal spirochetosis.
• To explore associations between spirochete invasion and symptoms.
• To identify risk factors for symptomatic IS.

Main Methods:

• Literature review of human intestinal spirochetosis cases.
• Histological examination for spirochete attachment and invasion.
• Correlation analysis of invasion status with clinical symptoms and patient demographics.

Main Results:

• Spirochete invasion beyond the epithelium may correlate with gastrointestinal symptoms responsive to metronidazole.
• Homosexuals, HIV-infected individuals, and children show higher symptomatic rates, regardless of invasion depth.
• Rare instances of spirochetemia and multiple organ failure are noted in critically ill IS patients.

Conclusions:

• The clinical significance of IS varies, with invasion potentially leading to treatable symptoms.
• Specific populations, including homosexual and HIV-positive men and children, are more prone to symptomatic IS.
• While generally superficial, IS can have severe systemic implications in rare, critical cases.