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10:37
Cultivation Methods of Spirochetes from Borrelia burgdorferi Sensu Lato Complex and Relapsing Fever Borrelia
Published on: November 25, 2022
Intestinal spirochetosis: an enigmatic disease.
Nicholas E Anthony1, James Blackwell, William Ahrens
1Department of Internal Medicine, Carolinas Medical Center, 1000 Blythe Blvd., Charlotte, NC 28203, USA. nicholas.anthony@carolinashealthcare.org
Digestive Diseases and Sciences
|August 2, 2012
Summary
Intestinal spirochetosis (IS) is a colonic condition often lacking inflammation. This study confirms IS is typically "bland," with symptoms like abdominal pain and diarrhea, and suggests metronidazole may be effective.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Intestinal spirochetosis (IS) involves epithelial cell colonization by Brachyspira aalborgi or Brachyspira pilosicoli.
- The pathogenic role of IS remains debated, with some viewing it as commensal.
Observation:
- A retrospective review of 26 IS cases (2003-2007) found symptoms including abdominal pain, diarrhea, and rectal bleeding.
- Most IS cases lacked significant inflammatory changes on pathology and endoscopy.
- Intraepithelial lymphocytes were increased in a subset of cases, a non-specific finding.
Findings:
- This study, the largest case series with endoscopic and pathologic data, confirms the typically "bland" nature of IS.
- Microscopic inflammation was present in less than 20% of cases and did not correlate with endoscopic appearance.
- Two patients treated with metronidazole showed positive response.
Implications:
- The findings support a pragmatic approach to IS evaluation and treatment due to the lack of established care standards.
- Further research is needed to clarify the clinical significance and optimal management of intestinal spirochetosis.
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