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Intestinal spirochetosis in children: report of two cases
Insights
Intestinal spirochetosis, a rare condition, was observed in two children. Treatment with antibiotics did not resolve symptoms in one case, highlighting the need for further research into its pathogenesis and management.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Intestinal spirochetosis is a colonic infection caused by anaerobic bacteria of the genus *Brachyspira*.
- It is uncommon in developed countries and its pathogenic role remains debated.
- Diagnosis is typically made via colonoscopic biopsies.
Observation:
- This report details two pediatric cases of intestinal spirochetosis.
- The first case involved a 7-year-old boy with diarrhea and rectal bleeding, diagnosed via rectal biopsy and treated with metronidazole and neomycin.
- The second case presented appendiceal spirochetosis incidentally in an 8-year-old girl with acute abdominal pain and mesenteric adenitis.
Findings:
- Despite antibiotic treatment and biopsy-confirmed clearance, the first patient's symptoms persisted.
- Appendiceal spirochetosis was an incidental finding in the second patient undergoing laparotomy for suspected mesenteric adenitis.
- The study discusses potential pathogenic mechanisms contributing to clinical manifestations.
Implications:
- The persistent symptoms in the first case suggest potential challenges in treating intestinal spirochetosis or other contributing factors.
- The incidental finding in the second case broadens the spectrum of clinical presentations associated with *Brachyspira* infections.
- Further investigation into the pathogenicity and optimal treatment strategies for intestinal spirochetosis in children is warranted.
Abstract:
Two cases of intestinal spirochetosis in two children are reported. The first patient, a 7 1/2-year-old boy, presented with diarrhea and rectal bleeding. After the diagnosis was made by a rectal biopsy, he was given metronidazole and neomycin. Symptoms persisted despite a further rectal biopsy that showed clearance of the organisms. Appendiceal spirochetosis was an incidental finding in our second patient, an 8-year-old girl who presented with acute abdominal pain and in whom mesenteric adenitis was diagnosed clinically at laparotomy. The possible pathogenic mechanisms causing clinical symptoms are discussed.