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Published on: September 22, 2019
Intestinal spirochetosis mimicking inflammatory bowel disease in children
Rossana Helbling1, Maria-Chiara Osterheld, Bernard Vaudaux
1Pediatric Gastroenterology Unit, Department of Pediatrics, University of Lausanne, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland.
Background:
Intestinal spirochetosis is an unusual infection in children and its clinical significance in humans is uncertain. The presence of these microorganisms in humans is well-known since the late 1800's and was first described in 1967 by Harland and Lee by electron microscopy.
Case Presentation:
This article reports the findings of one pediatric case, review of the current literature, and an overview of therapeutic options.
Conclusion:
A high degree of suspicion is required in cases presenting with abdominal pain, chronic diarrhoea and/or hematochezia associated with a normal endoscopic examination, thus emphasizing the importance of multiple biopsies throughout the colon.
Insights
Intestinal spirochetosis, a rare pediatric infection, presents diagnostic challenges. Early suspicion and multiple colonic biopsies are crucial for identifying this condition, often missed during standard endoscopy.
Area of Science:
- Medical Microbiology
- Pediatric Gastroenterology
Background:
- Intestinal spirochetosis is an uncommon enteric infection in children with uncertain clinical significance.
- First described in 1967, its human presence has been known since the late 1800s.
Observation:
- This report details a single pediatric case of intestinal spirochetosis.
- A comprehensive literature review on the topic was conducted.
Findings:
- The study highlights the importance of considering intestinal spirochetosis in pediatric patients with unexplained abdominal pain, chronic diarrhea, or hematochezia.
- Normal endoscopic findings can be misleading, underscoring the need for extensive colonic biopsies.
Implications:
- Increased clinical suspicion is vital for diagnosing intestinal spirochetosis in children.
- Multiple biopsies are essential for accurate diagnosis, especially when initial endoscopic examination is unremarkable.
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