Difference between revisions of "Intestinal spirochetosis"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Intestinal_spirochetosis_-_cropped_-_very_high_mag.jpg | |||
| Width = | |||
| Caption = Intestinal spirochetosis. [[H&E stain]]. | |||
| Synonyms = | |||
| Micro = hyperchromatic fuzz on luminal aspect of epithelial cells - at brush border; spirochetes | |||
| Subtypes = | |||
| LMDDx = | |||
| Stains = silver stains, e.g. [[Warthin-Starry stain]] | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = intestine - [[colon]] | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = watery diarrhea +/-blood per rectum | |||
| Symptoms = abdominal pain | |||
| Prevalence = uncommon | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = often normal | |||
| Prognosis = benign | |||
| Other = | |||
| ClinDDx = other causes of diarrhea | |||
| Tx = antibiotics | |||
}} | |||
'''Intestinal spirochetosis''', also known as '''intestinal spirochetes''', in an uncommon intestinal infection. | |||
It is usually in the [[colon]]; thus, also known as '''colonic spirochetes''' and '''colonic spirochetosis'''. | |||
==General== | |||
*Caused by spirochetes<ref name=pmid14718105>{{cite journal |author=Amat Villegas I, Borobio Aguilar E, Beloqui Perez R, de Llano Varela P, Oquiñena Legaz S, Martínez-Peñuela Virseda JM |title=[Colonic spirochetes: an infrequent cause of adult diarrhea] |language=Spanish; Castilian |journal=Gastroenterol Hepatol |volume=27 |issue=1 |pages=21–3 |year=2004 |month=January |pmid=14718105 |doi= |url=}}</ref><ref name=jhasim>URL: [http://www.jhasim.com/files/articlefiles/pdf/XASIM_Master_6_5_May_Vignette.pdf http://www.jhasim.com/files/articlefiles/pdf/XASIM_Master_6_5_May_Vignette.pdf]. Accessed on: 25 April 2011.</ref> - specifically ''Brachyspira piloicoli''<ref name=pmid19141744>{{Cite journal | last1 = Margawani | first1 = KR. | last2 = Robertson | first2 = ID. | last3 = Hampson | first3 = DJ. | title = Isolation of the anaerobic intestinal spirochaete Brachyspira pilosicoli from long-term residents and Indonesian visitors to Perth, Western Australia. | journal = J Med Microbiol | volume = 58 | issue = Pt 2 | pages = 248-52 | month = Feb | year = 2009 | doi = 10.1099/jmm.0.004770-0 | PMID = 19141744 | url = http://ukpmc.ac.uk/abstract/MED/19141744/abstract/MED/19141744?ukpmc_extredirect=http://dx.doi.org/10.1099/jmm.0.004770-0 }}</ref> (previously ''Serpulina pilosicoli''<ref>URL: [http://www.cdc.gov/ncidod/eid/vol12no05/05-1180.htm http://www.cdc.gov/ncidod/eid/vol12no05/05-1180.htm]. Accessed on: 28 June 2011.</ref>) and ''Brachyspira aalborgi''. | |||
*Very rare cause of diarrhea, associated with male homosexual behaviour. | |||
Symptoms:<ref name=jhasim>URL: [http://www.jhasim.com/files/articlefiles/pdf/XASIM_Master_6_5_May_Vignette.pdf http://www.jhasim.com/files/articlefiles/pdf/XASIM_Master_6_5_May_Vignette.pdf]. Accessed on: 25 April 2011.</ref> | |||
*Watery diarrhea, abdominal pain, +/-blood per rectum. | |||
Treatment:<ref name=pmid17914949>{{cite journal |author=Calderaro A, Bommezzadri S, Gorrini C, ''et al.'' |title=Infective colitis associated with human intestinal spirochetosis |journal=J. Gastroenterol. Hepatol. |volume=22 |issue=11 |pages=1772–9 |year=2007 |month=November |pmid=17914949 |doi=10.1111/j.1440-1746.2006.04606.x |url=}}</ref> | |||
*Metronidazole. | |||
==Gross== | |||
*Typically normal appearance. | |||
Note: | |||
*Anatomical distribution in large intestine varies - may be absent in rectum.<ref name=pmid25540866>{{cite journal |authors=Walker MM, Talley NJ, Inganäs L, Engstrand L, Jones MP, Nyhlin H, Agréus L, Kjellstrom L, Öst Å, Andreasson A |title=Colonic spirochetosis is associated with colonic eosinophilia and irritable bowel syndrome in a general population in Sweden |journal=Hum Pathol |volume=46 |issue=2 |pages=277–83 |date=February 2015 |pmid=25540866 |doi=10.1016/j.humpath.2014.10.026 |url=}}</ref> | |||
==Microscopic== | |||
Features: | |||
*Hyperchromatic fuzz on luminal aspect of epithelial cells; at brush border. | |||
DDx: | |||
*Normal colon. | |||
*[[Infectious colitis]] without a distinctive morphology. | |||
===Images=== | |||
<gallery> | |||
Image:Intestinal_spirochetosis_-_cropped_-_very_high_mag.jpg | Intestinal spirochetes - cropped - very high mag. (WC/Nephron) | |||
Image:Intestinal_spirochetosis_-_very_high_mag.jpg | Intestinal spirochetes - very high mag. (WC/Nephron) | |||
Image:Intestinal_spirochetosis_-_intermed_mag.jpg | Intestinal spirochetes - intermed. mag. (WC/Nephron) | |||
</gallery> | |||
www: | |||
*[http://path.upmc.edu/cases/case391.html Intestinal spirochetosis & CMV colitis - several images (upmc.edu)]. | |||
==Special stains== | |||
*Silver stains highlight 'em (e.g. [[Warthin-Starry stain]]). | |||
===Images=== | |||
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2830567/figure/F3/ Spirochetes shown with a Warthin-Starry stain (nih.gov)].<ref name=pmid20200654>{{Cite journal | last1 = Tsinganou | first1 = E. | last2 = Gebbers | first2 = JO. | title = Human intestinal spirochetosis--a review. | journal = Ger Med Sci | volume = 8 | issue = | pages = Doc01 | month = Jan | year = 2010 | doi = 10.3205/000090 | PMID = 20200654 }}</ref> | |||
==Sign out== | |||
<pre> | |||
Rectum, Biopsy: | |||
- Colonic-type mucosa with spirochetes, otherwise within normal limits. | |||
Comment: | |||
The presence of spirochetes was confirmed with a Warthin-Starry stain. | |||
</pre> | |||
==See also== | |||
*[[Colon]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Colon]] |
Latest revision as of 19:37, 22 February 2024
Intestinal spirochetosis | |
---|---|
Diagnosis in short | |
![]() Intestinal spirochetosis. H&E stain. | |
| |
LM | hyperchromatic fuzz on luminal aspect of epithelial cells - at brush border; spirochetes |
Stains | silver stains, e.g. Warthin-Starry stain |
Site | intestine - colon |
| |
Signs | watery diarrhea +/-blood per rectum |
Symptoms | abdominal pain |
Prevalence | uncommon |
Endoscopy | often normal |
Prognosis | benign |
Clin. DDx | other causes of diarrhea |
Treatment | antibiotics |
Intestinal spirochetosis, also known as intestinal spirochetes, in an uncommon intestinal infection.
It is usually in the colon; thus, also known as colonic spirochetes and colonic spirochetosis.
General
- Caused by spirochetes[1][2] - specifically Brachyspira piloicoli[3] (previously Serpulina pilosicoli[4]) and Brachyspira aalborgi.
- Very rare cause of diarrhea, associated with male homosexual behaviour.
Symptoms:[2]
- Watery diarrhea, abdominal pain, +/-blood per rectum.
Treatment:[5]
- Metronidazole.
Gross
- Typically normal appearance.
Note:
- Anatomical distribution in large intestine varies - may be absent in rectum.[6]
Microscopic
Features:
- Hyperchromatic fuzz on luminal aspect of epithelial cells; at brush border.
DDx:
- Normal colon.
- Infectious colitis without a distinctive morphology.
Images
www:
Special stains
- Silver stains highlight 'em (e.g. Warthin-Starry stain).
Images
Sign out
Rectum, Biopsy: - Colonic-type mucosa with spirochetes, otherwise within normal limits. Comment: The presence of spirochetes was confirmed with a Warthin-Starry stain.
See also
References
- ↑ Amat Villegas I, Borobio Aguilar E, Beloqui Perez R, de Llano Varela P, Oquiñena Legaz S, Martínez-Peñuela Virseda JM (January 2004). "[Colonic spirochetes: an infrequent cause of adult diarrhea]" (in Spanish; Castilian). Gastroenterol Hepatol 27 (1): 21–3. PMID 14718105.
- ↑ 2.0 2.1 URL: http://www.jhasim.com/files/articlefiles/pdf/XASIM_Master_6_5_May_Vignette.pdf. Accessed on: 25 April 2011.
- ↑ Margawani, KR.; Robertson, ID.; Hampson, DJ. (Feb 2009). "Isolation of the anaerobic intestinal spirochaete Brachyspira pilosicoli from long-term residents and Indonesian visitors to Perth, Western Australia.". J Med Microbiol 58 (Pt 2): 248-52. doi:10.1099/jmm.0.004770-0. PMID 19141744. http://ukpmc.ac.uk/abstract/MED/19141744/abstract/MED/19141744?ukpmc_extredirect=http://dx.doi.org/10.1099/jmm.0.004770-0.
- ↑ URL: http://www.cdc.gov/ncidod/eid/vol12no05/05-1180.htm. Accessed on: 28 June 2011.
- ↑ Calderaro A, Bommezzadri S, Gorrini C, et al. (November 2007). "Infective colitis associated with human intestinal spirochetosis". J. Gastroenterol. Hepatol. 22 (11): 1772–9. doi:10.1111/j.1440-1746.2006.04606.x. PMID 17914949.
- ↑ Walker MM, Talley NJ, Inganäs L, Engstrand L, Jones MP, Nyhlin H, Agréus L, Kjellstrom L, Öst Å, Andreasson A (February 2015). "Colonic spirochetosis is associated with colonic eosinophilia and irritable bowel syndrome in a general population in Sweden". Hum Pathol 46 (2): 277–83. doi:10.1016/j.humpath.2014.10.026. PMID 25540866.
- ↑ Tsinganou, E.; Gebbers, JO. (Jan 2010). "Human intestinal spirochetosis--a review.". Ger Med Sci 8: Doc01. doi:10.3205/000090. PMID 20200654.