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Intestinal Spirochetes Associated With Asymptomatic COVID-19 Infection
Olivier Van Houtte1, Gabrielle Perrotti2, Lindsey Gade3
1Colorectal Surgery, Cheshire Medical Center, Keene, USA.
Cureus
|August 30, 2022
Summary
This case highlights intestinal spirochetosis in an HIV-negative patient with COVID-19. This rare condition, causing chronic diarrhea, may be linked to coronavirus disease 2019 (COVID-19) infection.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Intestinal spirochetosis, caused by Brachyspira pilosicoli, is a rare cause of colitis typically seen in immunocompromised individuals.
- It presents with symptoms like abdominal pain and refractory diarrhea, often unresponsive to standard treatments.
Observation:
- A 60-year-old HIV-negative male with COVID-19 presented with prolonged abdominal pain and watery diarrhea.
- Initial infectious workup was negative; however, colonoscopy revealed microscopic colitis with spirochete colonization.
- Computed tomography showed colitis and lung base changes consistent with COVID-19.
Findings:
- Histopathology confirmed microscopic colitis with intestinal spirochete colonization.
- The patient's symptoms resolved after a course of metronidazole.
- This is a unique case of intestinal spirochetosis in an immunocompetent, COVID-19-positive patient.
Implications:
- This case suggests a potential association between COVID-19 and intestinal spirochetosis in immunocompetent individuals.
- Intestinal spirochetosis should be considered in the differential diagnosis of chronic diarrhea (lasting over two weeks) in COVID-19 patients.
- Further research is needed to confirm the link between COVID-19 and this condition.
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